J Korean Soc Emerg Med.  2009 Oct;20(5):488-495.

The Influence of Rotation Order on Medical Students' BLS Performance during the OSCE Examination

Affiliations
  • 1Department of Emergency Medicine, College of Medicine, Konyang University, Daejeon, Korea. emmam@catholic.ac.kr
  • 2Armed Forces Daejeon Hospital, Daejeon, Korea.

Abstract

PURPOSE: An objective structured clinical examination (OSCE) is an examination made up of a series of stations through which the candidate rotates to test clinical skill performance. This study was conducted to evaluate whether the testing ability changed and the basic life support (BLS) performance was influenced during the OSCE as a function of the time elapsed during the rotations.
METHODS
Candidates rotated around the 10 stations in 6 groups lasting 6 minutes each, for a total examination period of approximately 1 hour. For our analysis, 58 third-year medical students were divided into four groups by testing order; early, early-middle, late-middle, and latter. BLS performance scoring consisted of 50 points with 13 question items. We also analysed their objective BLS performance by Resusci(R) Anne Skill Report TM scoring results.
RESULTS
The total OSCE scores of each group were 404.8 +/-28.5, 395.8+/-18.7, 386.0+/-20.9, and 386.3+/-39.5 (p=0.187), respectively. The station scores were as follows: 40.8+/-5.4, 36.6+/-7.2, 34.2+/-6.1, and 33.7+/-6.2 for total BLS examination score (p=0.008), respectively; 2.5+/-2.6, 5.0+/-0.0, 4.7+/-1.2, and 5.0+/-0.0 for performance of sequence (p=0.000), respectively; 43.0+/-23.7%, 47.2+/- 17.6%, 12.7+/-2 2.0%, and 16.8+/-21.4% for adequate ventilation (p=0.000), respectively; and 77.3+/-21.5%, 62.8+/- 46.1%, 52.4+/-22.4%, and 31.3+/-36.1% (p=0.003) for adequate compressions, respectively. The general performance- related variables were lesser points in the early group. As the test progressed, accuracy decreased conspicuously in the middle groups. However, accuracy rose again, but fatigue-related scores were deteriorated in the latter group.
CONCLUSION
According to our study, the rotating order has exerted a strong influence on medical students' BLS performance and examination scores. Therefore, we should consider score distribution in the performance evaluation and accuracy of items to according to the rotation order during the OSCE examination.

Keyword

OSCE; Performance; Quality control; Cardiopulmonary resuscitation; Students

MeSH Terms

Cardiopulmonary Resuscitation
Clinical Competence
Humans
Quality Control
Students, Medical
Ventilation
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