Introduction of craniomaxillofacial surgery as a component of medical student training in general surgery.

PURPOSE: This study provides an overview of the objective structured clinical examination (OSCE) in concept, determination of task difficulty, execution, and evaluation by students and examiners. METHODS: During a 4-semester study period, 507 medical students completed a practical skills training (PST) course and subsequently participated in a 16-station OSCE, which contained 2 craniomaxillofacial surgical (CMS) stations covering the following key tasks: craniofacial examination and facial trauma fracture management. The students were rated using dedicated checklists. The students subjectively evaluated the PST and the OSCE using anonymous evaluation forms. RESULTS: Students rated the PST and OSCE as "very positive." The CMS OSCE stations were rated as having good task difficulty (74.05 ± 1.78% average task fulfilment for the examination and 74.45 ± 3.40% for the management station). With no changes to the examination station, no significant improvement of performance occurred over the entire investigation period (P = .787). In contrast, students improved slightly at the management station (P = .308). The CMS stations showed high selectivity and were representative in the overall context of the OSCE; improvement of selectivity increased from 0.259 ± 0.088 to 0.465 ± 0.109. CONCLUSION: CMS was successfully implemented in the general surgical training for medical students, with an initial PST and a final OSCE concordant with the literature. The CMS implementation effectively trained and fairly evaluated clinical skills. Although an OSCE consumes time and resources, this addition proved feasible and valuable, even with large numbers of students, and students expressed a high level of satisfaction with the training.

Long-term prospective teaching effectivity of practical skills training and a first OSCE in cranio maxillofacial surgery for dental students.

Basic skills in oral/CMF surgery should be taught effectively to dental students as surgical skills training is traditionally under-represented in the dental curriculum compared to its later need in daily clinical practice. Rigid curricular time frames and prospectively condensed professional education foster new effective teaching and examination formats. Transmitting and assessing clinical competence objectively (independent of subjective bias), reliably (repeatable, inter-rater consistency) and valid (representative, structured task selection) was intended and evaluated in oral/CMF surgery skills acquisition starting in summer 2009. A small-group practical skills training (PST) day initiated a one-week practical training course, covering previously formulated learning objectives. An objective structured clinical evaluation (OSCE) was held at the end of each semester. Theoretical background knowledge and clinical skills should have to be memorized within a representative number of practical tasks (test stations). A first semester (26 students) used classical practical training alone as controls, the following semesters (171 students) had PST, considered as a study group. All 197 students were assessed with OSCE's over a 3-year period. An instructor held PST based on presentations, videos and practical training, including mannequins, with pairs of students. This included history taking, communication and interpretation of laboratory/image diagnostics, structured clinical facial examination, fracture diagnosis, venipuncture, suturing, biopsy and wire loops on pig jaws for manual and clinical skills, which were later incorporated in OSCE stations. OSCE average results increased from 63.3 ± 9.7% before and to 75.5 ± 10% after the inclusion of PST (p < 0.05). Knowledge diffusion between sittings on the same test date and between consecutive semesters was insignificant. Students and faculty rated their learning/teaching experience "very good" to "good". PST was effective in optimizing clinical skills as evaluated by OSCE.

Development and implementation of an objective structured clinical examination (OSCE) in CMF-surgery for dental students.

OBJECTIVES: We introduced the OSCE (objective structured clinical examination) as a method of assessment in a problem-based learning (PBL) curriculum. The OSCE is a clinical competency test and a very good example of a practical performance (shows how) assessment instead of a theoretical written measurement (knows and knows how). The OSCE at this Department was designed to assess some of the skills that are supposedly gained during a PBL curriculum (skills such as critical thinking, problem-solving and hypothesis formation). The aim of this study was to find where the strengths and weaknesses of learning contents are during the CMF practical course and how we may raise the students' clinical competence. Furthermore we wanted to examine the possibility of achieving an OSCE with ten stations for a single department. MATERIAL AND METHODS: Students rotated through ten test stations of 5 min duration, separated by a 1 min changeover break. At each station the students' performance was observed and assessed by an examiner using a standardized multi-item checklist. All students of the eighth semester (n = 26) of the "Carolinum Dental Institute" at the University of Frankfurt were evaluated in summer 2009 in a ten station circuit of different topics, including trauma, practical knowledge and oncology. Following this all the students and examiners evaluated the OSCE. RESULTS: The overall average score was 63.2% (SD ± 8.89%). Subdivided the average results were; trauma (58.7 ± 6.79%), practical knowledge (66.1 ± 7.29%) and oncology (50 ± 4.81%). The overall rating of the OSCE was 1.69 (SD ± 0.78) for the students and 1.00 (SD ± 0) for the examiners. CONCLUSION: With good preparation, it is possible to run a ten station-OSCE circuit with ten examiners in one afternoon without interrupting patient care. The degree of difficulty was mainly acceptable. The overall average score for students' was within a range of 40-80%, which is similar to the international literature. The questionnaires showed that students and examiners viewed the new OSCE very positively.