Early formative objective structured clinical examinations for students in the pre-clinical years of medical education: A non-randomized controlled prospective pilot study

Naïm Ouldali; Enora Le Roux; Albert Faye; Claire Leblanc; François Angoulvant; Diane Korb; Clémence Delcour; Caroline Caula; Delphine Wohrer; Alexis Rybak; Manon Delafoy; Claire Carrié; Marion Strullu; Mehdi Oualha; Romain Levy; Camille Mimoun; Lucie Griffon; Alexandre Nuzzo; Clara Eyraud; Michael Levy; Pierre Ellul

doi:10.1371/journal.pone.0294022

Early formative objective structured clinical examinations for students in the pre-clinical years of medical education: A non-randomized controlled prospective pilot study

PLoS One. 2023 Dec 7;18(12):e0294022. doi: 10.1371/journal.pone.0294022. eCollection 2023.

Authors

Naïm Ouldali^{1

2

3

4}, Enora Le Roux⁴, Albert Faye^{1

3}, Claire Leblanc¹, François Angoulvant^{1

5}, Diane Korb^{6

7}, Clémence Delcour⁶, Caroline Caula⁸, Delphine Wohrer⁸, Alexis Rybak^{3

8}, Manon Delafoy⁹, Claire Carrié⁹, Marion Strullu⁹, Mehdi Oualha¹⁰, Romain Levy¹¹, Camille Mimoun¹², Lucie Griffon¹³, Alexandre Nuzzo¹⁴, Clara Eyraud⁴, Michael Levy¹⁵, Pierre Ellul^{16

17}

Affiliations

¹ Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France.
² Infectious Diseases Division, CHU Sainte Justine - Montreal University, Montreal, Quebec, Canada.
³ ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.
⁴ Paris Cité University, INSERM UMR 1137, IAME (Infection, Antimicrobials, Modelling, Evolution), Paris, France.
⁵ INSERM, Cordeliers Research Center, UMRS 1138, Sorbonne Université, Université Paris Cité, Paris, France.
⁶ Department of Obstetrics and Gynecology, Robert Debré University Hospital, Paris University, Paris, France.
⁷ Paris University, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France.
⁸ Pediatric Emergency Department, Robert Debré University Hospital, Paris Cité University, Paris, France.
⁹ Department of Hematology, Robert Debré University Hospital, Paris Cité University, Paris, France.
¹⁰ Pediatric Intensive Care Unit, Necker University Hospital, Paris Cité University, Paris, France.
¹¹ Immunology-Hematology and Rheumatology Department, Necker University Hospital, Paris Cité University, Paris, France.
¹² Department of Gynecology and Obstetrics, Lariboisiere Hospital, Paris Cité University, Paris, France.
¹³ Pediatric Non-Invasive Ventilation and Sleep Unit, Necker Hospital, Paris Cité University, Paris, France.
¹⁴ Department of Gastroenterology, IBD and Intestinal Failure, Beaujon Hospital, Paris Cité University, Paris, France.
¹⁵ Pediatric Intensive Care Unit, Robert Debré University Hospital, Paris Cité University, Paris, France.
¹⁶ Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Paris Cité University, Paris, France.
¹⁷ INSERM, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne University, Paris, France.

Abstract

Background: The value of formative objective structured clinical examinations (OSCEs) during the pre-clinical years of medical education remains unclear. We aimed to assess the effectiveness of a formative OSCE program for medical students in their pre-clinical years on subsequent performance in summative OSCE.

Methods: We conducted a non-randomized controlled prospective pilot study that included all medical students from the last year of the pre-clinical cycle of the Université Paris-Cité Medical School, France, in 2021. The intervention group received the formative OSCE program, which consisted of four OSCE sessions, followed by debriefing and feedback, whereas the control group received the standard teaching program. The main objective of this formative OSCE program was to develop skills in taking a structured medical history and communication. All participants took a final summative OSCE. The primary endpoint was the summative OSCE mark in each group. A questionnaire was also administered to the intervention-group students to collect their feedback. A qualitative analysis, using a convenience sample, was conducted by gathering data pertaining to the process through on-site participative observation of the formative OSCE program.

Results: Twenty students were included in the intervention group; 776 in the control group. We observed a significant improvement with each successive formative OSCE session in communication skills and in taking a structured medical history (p<0.0001 for both skills). Students from the intervention group performed better in a summative OSCE that assessed the structuring of a medical history (median mark 16/20, IQR [15; 17] versus 14/20, [13; 16], respectively, p = 0.012). Adjusted analyses gave similar results. The students from the intervention group reported a feeling of improved competence and a reduced level of stress at the time of the evaluation, supported by the qualitative data showing the benefits of the formative sessions.

Conclusion: Our findings suggest that an early formative OSCE program is suitable for the pre-clinical years of medical education and is associated with improved student performance in domains targeted by the program.

Copyright: © 2023 Ouldali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Clinical Trial
Controlled Clinical Trial

MeSH terms

Clinical Competence
Education, Medical*
Education, Medical, Undergraduate* / methods
Educational Measurement / methods
Humans
Pilot Projects
Prospective Studies
Students, Medical*

Grants and funding

The authors received no specific funding for this work.