Conducting Integrated Objective Structured Clinical Examination: Experiences at KIST Medical College, Nepal

Background: Objective structured clinical examination (OSCE), an important tool for assessment of clinical skills, introduced more than 4 decades ago. KIST Medical College, a new medical school of Nepal, affiliated to Tribhuvan University Institute of Medicine, has made learning of physical examination skills structured and integrated with greater involvement of different clinical science departments. Students learn physical examination skills in second year MBBS as a part of early clinical exposure. Objective: To share the experiences regarding implementation of integrated OSCE. Materials and Methods: At the end of clinical posting of learning of physical examination skills, assessment was done with OSCE. Fifteen OSCE stations including each of 5 minutes were developed and arranged. Standardized patients and validated checklist were used. OSCE was conducted in novel way. Prior to the OSCE session: Suitable venue was selected, assessors were identified, standardized patients were selected, running order of the stations in circuit was developed, list of equipments/instruments required was prepared, and tasks, checklists, feedback questionnaires were printed. The day before the OSCE session: OSCE stations were inspected and clearly labeled, condition of required equipments/instruments was checked, a pack of the documents for each OSCE station were made available, and signs were displayed at proper places. On the day of the OSCE session: Reliable stop watch and loud manual bell were used, support staffs were placed to direct the candidates, examiners, and standardized patients (SPs), assessors explained SPs, students were briefed, supervisors observed the session, and feedback were taken from students, assessors, and SPs. At the end of the OSCE session: Checklists and feedback questionnaires were collected, token money was paid to SPs, and a contribution of everyone was appreciated. After the OSCE session: Score was compiled and result declared, and feedback questionnaires data compiled and shared with academic team. Results: Ninety eight percent of the students attended the OSCE session. All agreed that standardized patient were co-operative, 93% found the faculty's presentation as non-threatening where as 99% found the overall OSCE environment conducive. Most (92%) of the faculties found the selection of simulated patients appropriate, and all were satisfied with student's approach towards SP. All expressed satisfaction with the overall management. Only 250 US dollars expended for conducting session. Conclusion: Integrated OSCE session was organized in novel way and cost effectively. Both students and faculty members were satisfied with OSCE process and management.