Improved detection of patient centeredness in objective structured clinical examinations through authentic scenario design

Abstract

Objective: In current objective structured clinical examinations (OSCEs), simulated encounters lacking realism reduce authenticity of assessment as students can take the OSCEs with a search-and-scan approach and trained empathy. Accordingly, patient-centeredness, the fundamental goal of OSCE, is not well assessed. This study evaluated the effect of a change in the OSCE scenario and checklist with respect to detecting students' patient-centeredness.

Methods: A scenario script for valid representation of a real clinical encounter was developed and defined as authenticated scenario. The OSCE scores and the measure of patient-centered communication (MPCC) scores of 79 medical students were compared between the two OSCE stations, one using the traditional scenario and another using the authenticated scenario.

Results: The MPCC total score was higher in the OSCE station using the authenticated scenario than that of the traditional scenario (p < 0.001). For the OSCE scores, the patient satisfaction score and the patient-physician interaction score were higher in the station using the authenticated scenario than the traditional one (p < 0.001).

Conclusion: The OSCE station using the authenticated scenario better detected medical student level of patient-centeredness.

Practice implications: Strengthening the authenticity of the OSCE scenario is critical for detecting the medical students' levels of patient-centeredness.

Keywords: Authenticity; Measure of patient centered communication; Objective structured clinical examination; Patient centeredness; Standardized patient.