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OSCE In Dentistry
BLUE PRINT OSCE DESIGN
MEI SYAFRIADI CORE TEAM KOMP 2 HPEQ KOLEGIUM DOKTER GIGI INDONESIA
Introduction • 1975 : OSCE was developed in Dundee, UK • 1986 : World Federation for Medical Education: Meeting on “Newer Developments in Assessing Clinical Competence “ • 1992 : International Conference on “Approach to the Assessment of Clinical Competence” • 1990 - now : OSCE become a routine.
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OSCE In Dentistry
Climbing the pyramid......
Does
Performance assessment in vivo: Mini-CEx, Video, Audits…..
Shows how Shows how
Performance assessment in vitro: OSCE, SP-based test…..
Knows how Knows how
(Clinical) Context based tests: MCQ, essay type, oral….. Factual tests: MCQ, essay type, oral…..
Knows Knows
OSCE
Format
Purpose
Advantages
Writing principles
Training observers
Scoring considerations
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OSCE In Dentistry
PREPARATION
1. Membuat daftar Penyakit/departemen sesuai dengan SKDGI No Bidang Ilmu 1
IKGA
2
KONSERVASI
Jenis Penyakit 1 Karies gigi anak, premature loss, trauma gigi, dll 1 Pulpitis Reversible/Irreversible, Trauma gigi (Fr Gigi) dll
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2. Tentukan relevansi tiap jenis penyakit
No
1
Jenis Penyakit
Fraktur rahang
relevansi Essensial Important Acceptable Question (diagnose- (diagnoseDiagnose- able terapi penanganan I) rujuk) Hanya danpenanga sekedar nan tahu) komplikasi) v
3. Menentukan jenis keterampilan sesuai dengan masing masing penyakit No Type of Skill
Brief Description
1
History Taking
This may be with a volunteer, real patient
2
Physical Examination Interpretation Skills Procedural Skills Communication Skills Attitude
Which can involve demonstrating your skill on a patient, a normal volunteer or a mannequin Applying your knowledge to clinical finding, data, radiographs, etc
3 4 5 6
Often use mannequins Interpersonal communication other than history taking. In standardized patient A short oral examination in which the examiner will probe your attitudinal approach to a particular situation
Dikutip dari : Dornan O’neill; Core Clinical Skills OSCEs in Medicine, 2006
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4. Menentukan level of Expected Ability level of expected ability 1
2
3
4
Deskripsi/Penjelasan Teori Mahasiswa menguasai dasar teori/pengetahuan yang meliputi prinsip, indikasi, kontra indikasi, resiko dan komplikasi tentang suatu tindakan atau ketrampilan klinis. Melihat atau Mendemonstrasikan Mahasiswa menguasai dasar teori/pengetahuan tentang suatu tindakan atau ketrampilan klinis dan pernah melihat serta mampu mendemonstrasikan. Melakukan atau Menerapkan dgn Pengawasan Mahasiswa menguasai dasar teori/pengetahuan tentang suatu tindakan atau ketrampilan klinis.dan dapat melakukan tindakan tersebut beberapa kali dengan bimbingan atau supervisi. Rutin/Mandiri Mahasiswa menguasai dasar teori/pengetahuan tentang suatu tindakan atau ketrampilan klinis dan berpengalaman (rutin) dalam melakukan tindakan tersebut
5. Tentukan jenis keterampilan apa yang dibutuhkan untuk tiap penyakit dan level of ability Nama penyakit
Fraktur Rahang
Jenis Keterampilan klinik
History taking
level of expected ability
1
2
3
Physical Examination
V
Interpretation Skill
V
Procedural Skill
4
V
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6. MENENTUKAN TOOLS/INSTRUMEN PEMBELAJARAN
KETERAMPILAN HISTORY TAKING
PHYSICAL EXAM SKILL
PURPOSE
SUMBER DAYA
Riwayat kasus
Pasien Standar (PS)
Pemeriksaan Klinis 1. Kondisi Umum & Extra Pasien Standar (PS) Oral : Vital Sign, kelenjar, tonus otot, simetrisitas, deviasi, TMJ 2. Intra Oral : Oral Hygiene, kelainan jar keras/lunak mulut
Model/Manikin/Foto Klinis
INTERPRETATION SKILL
Pemeriksaan penunjang
Model, Rekam Medik, Ro foto, Hasil Pemeriksaan lab
PROCEDURAL SKILL
Keterampilan Lab/klinik
Model, Rekam Medik, Instrumen Material
COMMUNICATION , INFORMATION & EDUCATION
Profesionalism & etik
Pasien Standar (PS), Model, Poster, Audio Visual
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DESIGN
• Blueprinting Osce •
A Mapping of test items (psychomotoric items) to specific learning/course
•
Ensures adequate sampling across subject area and skill domains
Sampling Domain of Interest
Test Sample
Test Sample
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STEPS Define/Select what is to be tested: Clinical problems at some Tasks for each problem
Select the OSCE methods:
Objectives • Match the items skill to Spesific learning/course • Methods: – By tool Instrument/tools list – By organ system – By patient age – By course located – By department – etc
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Organ System-based Competence Categories
CVS
RS
NB
Case
AMI (3B)
TB Lung
Febrile Conv. (SP)
GI
Repro
Obgyn Diarrhea (contrasepti (pediatric) on)
MSS
Endo/ Metab
Haem/ Oncology
Low Back Pain
Thyroid (SP)
DHF Grade 3-4 (adult) (SP)
HT fever
History Taking
Reflex Examination
Chest Xray
CPR
Management
Head & Neck
Special Sense
IV line
IM injection
Alloanamnesis
PE Thyroid
Suturing X-ray fracture
Phsyciatry
MildHearing Urinary Schizoprenia Retentio Moderate Dissorders (SP) n (3A, Head Injury (3A, depkes) (SP) depkes) (SP)
HT Thyroid
Physical Exam
Tests & Procedures
GUS
GCS
IV line
Assessment of hearing
Catheteri zation
Prescribe
Diet Counseling
Communication & Patient Education
On malnutrition
(peds)
Breaking bad news (breast malignancy)
Organ System-based Competence Categories
Head And Neck
Lymp honodi
Interpretation Skill
Gigi
Rahang
Lidah Etc
Lympha denitis Karies
Procedural skill
Communication,Infor mation and Patient Education
Jaringan Pendukung gigi
Mukokel
History Taking skill
Physical Exam Skill
Bibir
Periodontiti s Fraktur
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patient aged-based The Child Competence Categories
CVS
History Taking
RS
…
The Elderly GI
… ..
CVS
x
RS
…
GI
x
Physical Exam Tests and Procedures
…..
Course Located-System The Hospital Setting Competence CVS Categories
RS
…
GI
The Community Setting …..
CVS
RS
…
GI
History Taking Physical Exam Tests and Procedures Communica tion Information Education
x x
x x x
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Department/Division-based Penyakit akibat trauma dan kecelakaan
PSIKOMOTOR 1
2
3
4
5
6
7
8
TAKING HISTORY PYSICAL EXAM SKILL INTERPRETATION SKILL PROCEDURAL SKILL COMMUNICATION & Patient EDUCATION 1 2 3 4 5 6 7 8 Catatan
Oral Medicine Periodonsia Bedah Mulut Konservasi Prostodonsia Ortodonsia Pedodonsia IKGMP Oral Radiologi : integrated ke semua departemen
UKDGI OSCE BLUE PRINT
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GENERAL BLUE-PRINT for DENTISTRY MCQ (%)
OSCE (%)
Professionalism
10
10
2.
Application of basic medical and dental sciences
10
5
3.
General physical examination andstomatognatic system
25
40
4.
Management of stomatognatic functions System
25
30
5.
Oral and dental health
20
10
6.
Management of dental practices
10
5
100
100
DOMAIN
COMPETENCY
1.
Varieties of OSCEs Patient-based
Traditional OSCE SP-based test Station couplets Integral consultations
Written task
Clinical task
…. …. …. ….
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Key features of success in designing OSCEs
Feasibility
Congruence
Feasibility
Is it a reasonable task to expect the candidates to perform?
Can the task be examined at an OSCE station?
Can the task be performed in the time allowed?
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Feasibility
Is it a reasonable task to expect the candidates to perform? Is it authentic?
Can the task be examined at an OSCE station? Match clinical situations as closely as possible Some tasks may require simulated patients Some tasks may require manikins Some tasks simply cannot be examined in this format
Feasibility
Can task be performed in time allowed?
Pilot the stations to see if they are feasible
Check equipment /helpers/practicalities
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Congruence
Is it testing what you want it to test?
Station construct: describe what station is testing
Congruence
Ensure that all parts of station coordinate:
Candidate instructions
Marking schedule
Examiner instructions
Simulated patient instructions
Equipment
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