Assessing "EPA 6: Provide an Oral Presentation of a Clinical Encounter" During an OSCE Station
thesisposted on 27.11.2018 by Nazih Y Youssef
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ABSTRACT INTRODUCTION: Entrustable Professional activities were recently introduced in to Undergraduate Medical Education. We implemented a station in the post-Surgery clerkship Objective Structured Clinical Examination (OSCE) to provide entrustment for “EPA6: provide an oral presentation of a clinical encounter” that was never assessed in a summative manner. We looked for psychometric evidence supporting its use. METHOD: Medical students were assessed in two parallel stations using checklists developed according to the related sub-competencies. Assessors were trained using scoring rubrics elaborated according to the behaviors expected for entrusted learners. The validity of the scores were examined using the seven metrics described by Pell, et al. in 2010. RESULTS: twenty-six students were assessed. Twenty were fully entrusted or entrusted with minimal supervision. Our metrics’ values are as follow: Cronbach’s alpha is 0.963, and the coefficient of determination is 0.87. Moreover, the inter-grade discrimination equals 9.77%, whereas the failure rate is 3.8%. Furthermore, the difference between the average scores provided for the two groups is 0.26, p=0.947, and the difference between the average scores provided based on gender and religion are respectively 1.12, p=0.784 and 3.48, p=0.487. Finally, simulated patients (SPs) failed 11.54%. DISCUSSION: These results indicate the appropriateness of the checklists, the adequacy of the training, and the correctness of assessors and SPs behavior in granting scores. CONCLUSION: The psychometrics measured for our station support the use of a Post-Clerkship OSCE designed to measure entrustment in an oral presentation of a clinical encounter. Therefore, OSCE is an appropriate summative assessment tool for “EPA6: provide an oral presentation of a clinical encounter”.