Introduction and Implementation of OSPE as a Tool

for Assessment & Teaching / Learning in Physiology

138

1Dr. V. Suganthi

ABSTRACTIntroduction : Assessment drives learning. To improve learning, assessment needs to be more

objective, reliable and valid. Many institutions in India have shifted from their pattern of assessment

from Traditional practical exam (TPE) to Objective Structured Practical exams (OSPE). This study

has been conducted to evaluate the feasibility of use of OSPE as a valuable tool for asssessment as

well as learning in Physiology.

Materials and methods : 100 Students of I MBBS were assessed by both TPE & OSPE for two

experiments in examination of central nervous system in two groups. Cross over was done between

the groups for TPE & OSPE. Marks obtained in TPE & OSPE were compared. Student's and

faculty's perception of the use of OSPE for assessment were obtained using questionnaires.

Statistical analysis & results : The mean scores in TPE and OSPE were compared using paired t

test and p value was <0.0001 and was highly significant. The students and faculty felt that that OSPE

pattern was more objective, tested the clinical skills and knowledge better and was unbiased.

Feedback given to students about their performance helped them in learning.

Conclusion : Use of OSPE as an assessment tool for formative assessment is feasible in Physiology

curriculum. It also helps in learning.

Key words : OSPE, Formative assessment, objectivity, reliable.

INTRODUCTION:

eaching the medical students and

assessment of their knowledge and skills Tare always a complicated issue.

Assessment is very important as it drives learning.

Assessment has to be more objective, reliable &

valid, so that it helps in learning. Assessment of

cognitive domain has changed from a more

subjective type, like long essay questions to more

objective pattern by using MCQs / short answers.

Assessments of clinical skills / practical

examinations are still done by conventional /

traditional practical examinations (TPE) which are 1more subjective

In TPE, the assessments are more subjective and

there are no assessment techniques for various

competencies. There is no uniform marking pattern

by the examiners and it may be subjected to

examiner bias. There needs to be an objective

assessment pattern for psychomotor skills 2

assessment . Especially in physiology, the students

are introduced to various human experiments like

Examination of arterial pulse, recording of arterial

blood pressure and the clinical examinations of

Cardiovascular, Respiratory & Nervous systems.

The TPE which is being used in our institution for

both formative and summative assessments gives

an overall view of the performance of the student

rather than assessment of individual skills. So we

Address for correspondence:

Dr. V. Suganthi, Associate Professor, Department of Physiology, Vinayaka Mission's Kirupananda Variyar Medical College, Salem

E mail : vsuganthiarasan@gmail.com Mobile no: 9443908855

1Associate Professor, Department of Physiology, Vinayaka Mission's Kirupananda Variyar Medical College, Salem.

http://dx.doi.org/10.31975/NJBMS.2019.9306

Original Article

National Journal of Basic Medical Sciences | Volume 9 | Issue 3 | 2019

139

need to introduce an objective examination pattern 1, 2

to overcome these limitations .

OSCE (Objec t ive S t ruc tu red C l in i ca l

Examination), an objective method of assessment

was introduced by Harden (1975) in Dundee

University for objective assessment of clinical 3skills . It includes rotation of students to many

stations were individual competencies are tested

and uniform marking pattern is used. A similar

pattern of assessment, the OSPE (Objective

structured practical examination), is being used in

the pre & paraclinical subjects in many Universities 4in India .

OSPE is not implemented in our University. So we

have tried using OSPE for formative assessment of

few of the clinical experiments in Department of

Physiology and have analysed the effectiveness of

OSPE over TPE for assessment as well as a

teaching / learning tool and have obtained feedback

from faculty & students about their perceptions in

using OSPE.

OBJECTIVES :

ª To plan and implement OSPE as a method of

learning and assessment of clinical skills in

Physiology curriculumª To compare the marks obtained in OSPE and

TPE ª To obtain feedback from students & faculty

regarding OSPE as an assessment & teaching

tool

MATERIALS & METHODS :

st100, 1 MBBS students (2015-16 batch) were

included in the study. TPE & OSPE were conducted

in Central Nervous System in 2 topics after

obtaining the Institutional ethical clearance.

Written informed consent was obtained from the

students. Students were given proper instructions

regarding the conduct of OSPE and a mock session

of OSPE was conducted in a different topic to make

them familiar to the technique. Faculties were

involved in the discussion of conduct of the

exercise. The questions were framed following a

discussion with the subject experts. Students were

divided into two groups; A & B.

TPE and OSPE pattern of tests were conducted for

two topics in Central nervous system practical

experiment. Group A students had OSPE for one

topic and Group B students had TPE pattern of

exam for the other topic. In the next session, the

exam patterns and topics were inter-changed for the

groups.

For each experiment, for each batch, there were 4

unobserved stations and two skills; procedural

stations and one rest station. Subject experts were

observers in the procedural stations. They were

given checklists with marks alloted for each

component being assessed. Total marks for both

TPE & OSPE were 30 each. The unobserved

stations had questions to assess cognitive, problem

solving and analytic skills. Feedback about their

performance and corrections were given to students

after the OSPE (as part of learning) and their

querries were cleared.

Feedback was obtained from faculty and students

with validated questionnaire about the use of OSPE

as a tool of assessment and teaching and their

responses were analyzed.

STATISTICAL ANALYSIS & RESULTS :

The mean scores obtained by both the batches by

TPE & OSPE were compared using paired t test and

p value was <0.0001 and was highly significant

(Table 1). The performance of students by OSPE

was better, mean scores were 13.92 5.9 & 17.6 4.6

for TPE & OSPE respectively. Feedback

questionnaire obtained from faculty and students

V. Suganthi, et.al : OSPE a tool for assessment & learning

National Journal of Basic Medical Sciences | Volume 9 | Issue 3 | 2019

140

were analyzed by qualitative analysis. The

students' (Fig 1) and faculty feedback (Fig 2)

implies that OSPE pattern was more objective,

tested the clinical skills and knowledge better, it

was unbiased and scoring of marks with OSPE was

better. They also felt the feedback given to students

after the OSPE helped them in their learning.

Table1: Mean and standard deviation of marks

obtained in TPE & OSPE, p value derived by

paired t test

Figure 1: Evaluation of feedback forms of

students

Figure 2: Evaluation of feedback form of

faculty:

DISCUSSION :

In our Institution, assessment of practical skills,

both formative and summative are done by

traditional methods. Many colleges and

Universities have started using OSPE/OSCE for

assessment in formative as well as summative 5

exams . So this study was undertaken to check the

feasibility of using this type of assessment in our

institution.

The results of this study have been very fruitful as

the student's performance in OSPE was better than

the TPE, based on the scores obtained by the

students (Table 1). In OSPE type of assessment all

students of one batch (A or B) were exposed to

same set of questions and psychomotor skills

assessment and scoring were based on preformed

checklist and therefore the assessment was uniform

for all students. In TPE students used to complain

about the inequality of marks given by the

examiners and selection of experiments were based

on picking up lots and lot of uncertainities in

assessment were possible with TPE. OSPE, being

an objective, valid and reliable tool of assessment,

has overcome all the above said uncertainities of

TPE.

OSPE is a better tool of assessment as it can assess

all three domains – Cognitive (analytical questions

in unobserved stations), psychomotor (step-wise

demonstrations of procedures) and affective 6(Communication skills) .

Student's feedback on this pattern of assessment

was positive and they felt that the clinical skills and

knowledge were adequately and uniformly tested

and the examiner bias was eliminated. Some

students have given feedback that it was stressful as

this was the first time they were exposed to OSPE.

Similar results were seen in the study conducted by 7

Mohan et al .

Students and faculty have also recommended the

usage of OSPE as a better assessment tool than

TPE. Faculties have suggested that OSPE was more

National Journal of Basic Medical Sciences | Volume 9 | Issue 3 | 2019

V. Suganthi, et.al : OSPE a tool for assessment & learning

141

objective and clinical skills were better tested and it

has eliminated examiner bias. They had also

recommended the use of OSPE for formative

assessment and later for summative assessment.

But the amount of time taken to arrange for the

conduct of OSPE and preparations for the

questions, checklist for skill observation require lot 8

of time and man power . These are the drawbacks

for conducting OSPE.

Feedback given by the teachers to the students after

the exam helped them to correct their mistakes and

they became aware about what was expected from

them in that particular experiment and therefore

OSPE has helped them to learn procedures in a

systematic manner. Therefore OSPE can also be 4

used as a teaching/learning tool .

Our results are comparable to many other studies

conducted in Pakistan and other parts of India that 8,9OSPE is a preferred tool of assessment over TPE .

Now since the undergraduate curriculum is being

revised as a competency based education OSPE

will be a valid tool as it motivates the students to

learn the procedures and clinical skills in a

systematic and step-wise manner.

LIMITATIONS :

We could conduct OSPE only for two experiments

and therefore the results and conclusions drawn are

from restricted data.

CONCLUSION :

OSPE is a better tool to test practical & clinical

skills in Physiology as it is more reliable, objective

and free of examiner bias. It has been well accepted

and appreciated by the students and faculty and

therefore could be recommended for using OSPE

as a tool for teaching and assessment in Physiology.

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National Journal of Basic Medical Sciences | Volume 9 | Issue 3 | 2019

Received on 10/01/2019 Revised on 08/02/2019 Accepted on 16/02/2019

V. Suganthi, et.al : OSPE a tool for assessment & learning