Comparison of OSCE performance between 6- and 7-year medical school curricula in Taiwan

BMC Medical Education

Ming-Chih Hou¹  Wayne Huey-Herng Sheu²  Ling-Yu Yang³  Jen-Feng Liang³  Chen-Huan Chen³  Shiau-Shian Huang³  Hao-Min Cheng⁴  Jr-Wei Wu⁵  Ying-Ying Yang⁶  Chia-Chang Huang⁷  Boaz Shulruf⁸ 

[1] College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;Institute of Medical Technology, College of Life Science, National Chung-Hsing University, Taichung, Taiwan;Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan;College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan;College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan;College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan;Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan;College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan;Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan;Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan;College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan;University of New South Wales, Sydney, Australia;

关键词: Curricular reform;    Curricular length;    OSCE;    Clinical skills;    Sub-internship;    Competency-based medical education;   

DOI  :  10.1186/s12909-021-03088-7

来源: Springer

【 摘 要 】

BackgroundThe year 2013 marks a watershed in the history of medical education in Taiwan. Following Taiwan’s Taskforce of Medical School Curriculum Reform recommendations, the medical school curriculum was reduced from 7 to 6 years. This study aimed to analyze the impact of medical school curriculum reform on medical students’ performance in objective structured clinical examinations (OSCEs).MethodsWe retrospectively analyzed the OSCE records at Taipei Veterans General Hospital (Taipei VGH), one of Taiwan’s largest tertiary medical centers, between November 2016 and July 2020. The eligibility criteria were medical students receiving a full one-year clinical sub-internship training at Taipei VGH and in their last year of medical school. All medical students received a mock OSCE-1 at the beginning of their sub-internship, a mock OSCE-2 after six months of training, and a national OSCE at the end of their sub-internship. The parameters for performance in OSCEs included “percentage of scores above the qualification standard” and “percentage of qualified stations.”ResultsBetween November 2016 and July 2020, 361 undergraduates underwent clinical sub-internship training at Taipei VGH. Among them, 218 were taught under the 7-year curriculum, and 143 were instructed under the 6-year curriculum. Based on baseline-adjusted ANCOVA results, medical students under the 7-year curriculum had a higher percentage of scores above the qualification standard than those under the 6-year curriculum at the mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 33.8% [95% CI 32.0–35.7] vs. 28.2% [95% CI 25.9–30.4], p < 0.001), and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p = 0.001). Moreover, medical students in the 7-year curriculum had a higher percentage of qualified stations in mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p = 0.001) and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 91.9% [95% CI 90.1–93.8] vs. 86.1% [95% CI 83.8–88.3], p = 0.001). After clinical sub-internship training, there were no differences in the percentage of scores above the qualification standard (7-year curriculum vs. 6-year curriculum: 33.5% [95% CI 32.2–34.9] vs. 34.6 [95% CI 32.9–36.3], p = 0.328) and percentage of qualified stations (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 88.1–90.7] vs. 90.2% [95% CI 88.6–91.8], p = 0.492).ConclusionsAt the beginning of the sub-internship, medical students under the 7-year curriculum had better OSCE performance than those under the 6-year curriculum. After the clinical sub-internship training in Taipei VGH, there was no difference in the national OSCE score between the 6- and 7-year curricula. Our study suggests that clinical sub-internship is crucial for the development of clinical skills and performance in the national OSCE.

【 授权许可】

CC BY