Objective structured clinical examination in physical therapist education.

摘要

Background. Many studies in the medical and nursing literature support the use of Objective Structured Clinical Examinations (OSCEs) for evaluation of clinical competence; however, only one study examines the OSCE in physical therapist education. The purpose of this research study was threefold: (1) To determine the reliability of an OSCE for physical therapist students; (2) To determine if physical therapist student performance altered with differing exam preparation methods; and (3) To examine physical therapist students' satisfaction with taking the OSCE with student-trained standardized patients (SPs) compared to nurse practitioner students' satisfaction with lay persons trained as SPs.; Method. Data was collected from 65 physical therapist students from two different physical therapist programs and 40 nurse practitioner students. The physical therapist students took an OSCE that utilized students trained as SPs, and the OSCE was considered their mid-term practical exam in a musculoskeletal course. The physical therapist students were randomized to a rubric exam preparation group and a non-rubric exam preparation group. The nurse practitioner students took an OSCE that utilized lay persons trained as SPs, and the OSCE was considered the final examination for a health assessment course. Upon completion of their respective OSCE, all students completed a post exam survey on their satisfaction with their SP experience.; Results. This study found that the interrater reliability among examiners was high for the total score given in the exam for all students (ICC=0.77). The internal consistency approached an acceptable level (Cronbach's alpha = 0.55) for the performance scores of the OSCE. The results of the 2X2 ANOVA that examined student performance between exam preparation groups indicated a significant interaction between the group assignment and program, F (1,191) = 12.96, p0.001. The results of the 2X2 ANOVA that examined the student satisfaction scores between the rubric and non-rubric groups were not significant. Lastly, the results of the ANOVA that examined the student satisfaction scores between lay persons and students trained as SPs indicated a significant difference between groups (p0.001).; Discussion/conclusion. The primary outcome of this research study provides evidence of a reliable tool that can potentially be used across physical therapist education programs. Second, physical therapist programs should consider exam preparation methods when implementing OSCE formatted exams into the curriculum. Lastly, although the student satisfaction with student-trained SPs appeared to be lower, the majority of students who interacted with student-trained SPs was either neutral or believed the SP encounter to be realistic, useful and challenging.