Objective standardized clinical assessment with feedback: Adapting the objective structured clinical examination for postgraduate psychiatry training in India.

Full Abstract

BACKGROUND: The objective structured clinical examination (OSCE) is used commonly for assessment of psychiatry trainees but has been used less for teaching. AIM AND SETTING: This study describes the adaptation of the OSCE method for training purposes in a postgraduate psychiatry training center in India and the initial findings with regard to trainee performance. MATERIALS AND METHODS: The adapted method was called the objective structured clinical assessment with feedback (OSCAF). The adaptation included several steps--modifying existing OSCE patterns for language and cultural appropriateness, using supervised roleplaying instead of standardized or simulated patients and evolving an assessment method (14-item checklist) that would generate feedback. This exercise was conducted in front of a group of multidisciplinary peers and supervisors. STATISTICAL ANALYSIS: Descriptive statistics and ANOVA were used. RESULTS: Analysis of the performance based on the 14-item checklist assessing common elements of any patient-related interaction in 34 different OSCAF tasks indicated the following: less-than-satisfactory (<75%) performances in the following areas--assuring confidentiality (73.5%), assessing comfort (62%), summarizing (60%), closure (62%) and checking whether the 'patient' had understood what was being communicated (42%). Based on the nature of clinical situations, performances on some specific and difficult OSCAF situations were found to be inadequate and indicated need for further training. CONCLUSIONS: We have been able to demonstrate OSCAF to be a convenient, cost-effective training method in psychiatry, with limited demands on resources; however, further refinements in ratings and feedback methods and studies on effectiveness may enhance its utility.

Author information

Author/s: Chandra, Prabha S (PS); Chaturvedi, Santosh K (SK); Desai, Geetha (G);

Affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India. prabhasch(-atsign-)gmail.com

Journal and publication information

Publication Type: Journal Article

Journal: Indian journal of medical sciences (Indian J Med Sci), published in India. (Language: eng)

Reference: 2009-Jun; vol 63 (issue 6) : pp 235-43

Dates: Created 2009/07/15; Completed 2009/10/07;

PMID: 19602757, status: MEDLINE (last retrieval date: 10/7/2009, IMS Date: )

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