How to develop a competency-based examination blueprint for longitudinal standardized patient clinical skills assessments.
ABSTRACT Background: Objective Structured Clinical Exams (OSCEs) with standardized patients (SPs) are commonly used in medical education to assess learners' clinical skills. However, assessments are often discrete rather than intentionally developmentally sequenced. Aims: We developed an examination blueprint to optimize assessment and feedback to learners with purposeful sequence as a series of longitudinally integrated assessments based on performance milestones. Integrated and progressive clinical skills assessments offer several benefits: assessment of skill development over time, systematic identification of learning needs, data for individualized feedback and learning plans, and baseline reference points for reassessment. Methods: Using a competency-based medical education (CBME) framework, we translated pre-determined competency milestones for medical students' patient encounters into a four-year SP-based OSCE examination blueprint. Results: Initial evaluation of cases using the blueprint revealed opportunities to target less frequently assessed competencies and to align assessments with milestones for each year. Conclusions: The examination blueprint can guide ongoing SP-based OSCE case design. Future iterations of examination blueprints can incorporate lessons learnt from evaluation data and student feedback.
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ABSTRACT: The traditional clinical examination has been shown to have serious limitations in terms of its validity and reliability. The OSCE provides some answers to these limitations and has become very popular. Many variants on the original OSCE format now exist and much research has been done on various aspects of their use. Issues to be addressed relate to organization matters and to the quality of the assessment. This paper focuses particularly on the latter with respect to ways of ensuring content validity and achieving acceptable levels of reliability. A particular concern has been the demonstrable need for long examinations if high levels of reliability are to be achieved. Strategies for reducing the practical difficulties this raises are discussed. Standard setting methods for use with OSCEs are described.Medical Education 03/2004; 38(2):199-203. · 3.62 Impact Factor
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ABSTRACT: Outcomes-based education in the health professions has emerged as a priority for curriculum planners striving to align with societal needs. However, many struggle with effective methods of implementing such an approach. In this narrative, we describe the lessons learned from the implementation of a national, needs-based, outcome-oriented, competency framework called the CanMEDS initiative of The Royal College of Physicians and Surgeons of Canada. We developed a framework of physician competencies organized around seven physician "Roles": Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar, and Professional. A systematic implementation plan involved: the development of standards for curriculum and assessment, faculty development, educational research and resources, and outreach. Implementing this competency framework has resulted in successes, challenges, resistance to change, and a list of essential ingredients for outcomes-based medical education. A multifaceted implementation strategy has enabled this large-scale curriculum change for outcomes-based education.Medical Teacher 10/2007; 29(7):642-7. · 2.05 Impact Factor
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ABSTRACT: The Tuning Project is an initiative funded by the European Commission to develop learning outcomes/competences for degree programmes in Europe and to promote harmonisation in the Higher Education sector. It is closely linked to the Bologna Declaration and subsequent developments. Under the auspices of the MEDINE Thematic Network for Medical Education in Europe, the Tuning (Medicine) Task Force has generated a draft set of learning outcomes for primary medical degree qualifications in Europe. These take account of previous work on learning outcomes in medicine, have been generated through an iterative process of expert review and development, and have been the subject of a Europe-wide internet-based opinion survey and subsequent analysis. They have been approved by the MEDINE Network and validated (subject to some additional analysis) by an Expert Panel of the European Commission.Medical Teacher 10/2007; 29(7):636-41. · 2.05 Impact Factor