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Abstract Details

Actor and Patient Scoring in Neurology OSCEs: A Valuable Dimension in the Assessment of Communication Skills and Professionalism of Medical Students.
Research Methodology, 好色先生, and History
S44 - Research Methodology and 好色先生 (4:54 PM-5:06 PM)
008
Ascertain the value of actor/patient scoring in medical student assessment.

Traditionally, student Observed Structured Clinical Examinations (OSCEs) are assessed solely by senior clinicians, with patients/actors not contributing formally to student grades. The extent to which patients understand instructions and/or feel comfortable with the comportment of students in conducting the OSCE task is often overlooked. Clinical Neurology at Oxford Medical School is part of an 8-week module culminating in an OSCE where students are exposed to six-minute stations that assess various domains, including history, neurological examination, and interpretation/explanation of investigations. These stations all contain an actor/patient alongside a clinician examiner.

Hypothesis: Inclusion of actor/patient scores in OSCEs provide valuable insight into the professionalism of students not captured by clinician examiners.


During the 2018-19 academic year, both clinician examiners and patients/actors independently recorded numeric scores (4-point scale; 1-clear fail; 2-borderline fail; 3-clear pass; 4-above expected) and comments for each student passing through the station.  Quantitative and qualitative analyses of the numeric scores and written comments, respectively, were undertaken.
A total of 162 students undertook the OSCE. Overall, no difference in examiner and actor/patient scores was observed across the OSCE assessment domains. However, discrepant scores between examiners and actors/patients (i.e. pass (3 or 4) versus fail (1 or 2)), tended to occur in stations where communication is an essential component of the station (i.e. history or interpretation/explanation of investigations).  On preliminary analysis, examiner comments focussed on diagnosis and management whereas actor/patient comments focussed on clarity of language, communication style, and professionalism. Formal thematic analyses of comments from both clinician and actor/patient examiners is ongoing with results soon to be available.
Preliminary analyses suggest that actor/patient scoring in neurology OSCE stations adds a valuable dimension to the assessment of communication and professionalism of medical students that may not be captured in clinician scoring alone.
Authors/Disclosures
Gina L. Hadley, MD (work)
PRESENTER 		Dr. Hadley has nothing to disclose.
Gabriele C. De Luca, MD, DPhil, FRCPath, FAAN (University of Oxford) Dr. De Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurology Academy. Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. De Luca has received research support from NIHR, BRC (Oxford). The institution of Dr. De Luca has received research support from National Health and Medical Research (Australia). The institution of Dr. De Luca has received research support from UK MS Society. The institution of Dr. De Luca has received research support from Oxford-Quinnipiac Partnership. The institution of Dr. De Luca has received research support from US Department of Defense. The institution of Dr. De Luca has received research support from Wellcome ISSF (Oxford). The institution of Dr. De Luca has received research support from Bristol Myers Squibb. The institution of Dr. De Luca has received research support from University of Oxford (John Fell Fund). The institution of Dr. De Luca has received research support from National Health and Medical Research (Australia). Dr. De Luca has a non-compensated relationship as a Editorial board member with MS Journal that is relevant to AAN interests or activities. Dr. De Luca has a non-compensated relationship as a Vice-Chair of Grant Review Panel with UK MS Society that is relevant to AAN interests or activities. Dr. De Luca has a non-compensated relationship as a Steering Group member with MS Academy that is relevant to AAN interests or activities. Dr. De Luca has a non-compensated relationship as a Board of Directors with SEQUINS that is relevant to AAN interests or activities.