Situational awareness within objective structured clinical examination stations in undergraduate medical training - a literature search

Abstract

BackgroundMedical students may not be able to identify the essential elements of situational awareness (SA) necessary for clinical reasoning. Recent studies suggest that students have little insight into cognitive processing and SA in clinical scenarios. Objective Structured Clinical Examinations (OSCEs) could be used to assess certain elements of situational awareness. The purpose of this paper is to review the literature with a view to identifying whether levels of SA based on Endsley’s model can be assessed utilising OSCEs during undergraduate medical training.MethodsA systematic search was performed pertaining to SA and OSCEs, to identify studies published between January 1975 (first paper describing an OSCE) and February 2017, in peer reviewed international journals published in English. PUBMED, EMBASE, PsycINFO Ovid and SCOPUS were searched for papers that described the assessment of SA using OSCEs among undergraduate medical students. Key search terms included “objective structured clinical examination”, “objective structured clinical assessment” or “OSCE” and “non-technical skills”, “sense-making”, “clinical reasoning”, “perception”, “comprehension”, “projection”, “situation awareness”, “situational awareness” and “situation assessment”. Boolean operators (AND, OR) were used as conjunctions to narrow the search strategy, resulting in the limitation of papers relevant to the research interest. Areas of interest were elements of SA that can be assessed by these examinations.ResultsThe initial search of the literature retrieved 1127 publications. Upon removal of duplicates and papers relating to nursing, paramedical disciplines, pharmacy and veterinary education by title, abstract or full text, 11 articles were eligible for inclusion as related to the assessment of elements of SA in undergraduate medical students.DiscussionReview of the literature suggests that whole-task OSCEs enable the evaluation of SA associated with clinical reasoning skills. If they address the levels of SA, these OSCEs can provide supportive feedback and strengthen educational measures associated with higher diagnostic accuracy and reasoning abilities.ConclusionBased on the findings, the early exposure of medical students to SA is recommended, utilising OSCEs to evaluate and facilitate SA in dynamic environments.

Assessing core competences of medical students with a test for flight school applicants

“…Interestingly, medical students in semester 10 (year 5 of a six-year undergraduate medical curriculum) showed significantly higher scores for awareness than final year students with a medium effect but also below the acceptance level for flight school applicants. Awareness is an important core competence for physicians to perform clinical reasoning [19] and to reduce surgical errors in the operating room [20]. In a systematic review on competences to enhance patient safety, awareness emerged as one of the five key themes [21].…”

The Effects of Case-Based Teaching in Nursing Skill Education: Cases Do Matter

“…Objective structure clinical examination (OSCE) required the students to finish multiple examination within the prescribed time to complete the examination content of each station, and the final comprehensive score was used for the result evaluation. 13 (1) Scope of skill test items: including bed sheet replacement, oral care, pressure ulcer prevention care, vital signs measurement, oxygen supply, and intradermal injection; (2) Test method: case-based assessment. According to the scope of the skill test, 1 clinical case was set for each operation, and a total of 6 test cases were composed; (3) Examination format: OSCE 3-stop assessment, that is, nursing evaluation-nursing care practice-health education.…”

“…Objective structure clinical examination (OSCE) required the students to finish multiple examination within the prescribed time to complete the examination content of each station, and the final comprehensive score was used for the result evaluation. 13 (1) Candidates draw a case number in the station, and the test begins to time. The completion time of each station is 10 minutes.…”

Objective Structured Clinical Examination (Osce) as a Reliable Evaluation Strategy: Evidence From a Brazilian Medical School

“…Of note, there are different types of assessment approaches and professors should always take into consideration which one is the most appropriate to assess whether the objectives of a given course and/or discipline have been achieved by students. The Structured Objective Clinical Examination (OSCE) is one of these assessment tools already successfully tested in different courses, including medical schools (Carraccio & Englander, 2000;Fischer et al, 2017;Kolivand et al, 2020). It is designed to test, in a practical way and in a controlled environment, the performance of clinical and main medical skills.…”