Assessment Using Simulation and Role Play
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Introduction
Although most education occurs within the context of real patient care, simulation and role play are becoming increasingly used (Issenberg et al, 2005). This is especially true for the early stages of learning, when risk of harm is greatest.
Use of OSCEs
OSCEs have been used for formative assessment, to good effect (Brazeau, Boyd, and Crosson, 2002).
Standardized Patients
Standardized patients (SPs) have been used in North America for many years. These are often embedded within clincial scenarios with criterion-based marking - objective standardized clinical exams, or OSCE.
Often a number of stations will be used at one time; reliability of a 10 station series has been reported as being 0.85-0.90 (Reznick et al, 1993).
SPs can be customized according to specific educational goals. SPs can also be used to administer assessments.
Simulators
Simulators have been used since the 1960s or earlier to teach procedural-based competencies, especially in regards to critical illness, surgery, and minor procedures.
High-fidelity simulators can be interesting and are increasingly used in medical training in well-developed countries. However, research increasingly shows that high-fidelity simulators do not offer much benefit over low-fidelity approaches (Norman, Dowe, and Grierson, 2012).
Advice and Strategies
When walk into OSCE station, are given PMHx, Meds, Alls, Social, Healthy Living on a sheet. Walk in to "Undifferentiated Patient".
have OSCE be marked out of 5 points
hx (1)
px (1)
differential diagnosis (1-2)
treatment plan (1-2)
need to get 60% per station; debrief re: each.
Resources and References
Brazeau C, Boyd L, Crosson J. 2002. Changing an existing OSCE to a teaching tool: the making of a teaching OSCE. Acad Med. 77(9):932.
Hall AK, Pickett W, Dagnone JD. 2012. Development and evaluation of a simulation-based resuscitation scenario assessment tool for emergency medicine residents. CJEM. 14(3):139-46.
Reznick RK et al. 1993. An OSCE for the licentiate of the MCC, from research to reality. Acad Med. 68:S4-S6.
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