Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 283942

AbstractMaterial and MethodsResultsDiscussionConclusionAcknowledgementReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : January | Volume : 16 | Issue : 1 | Page : JC12 - JC16 Full Version

Feedback Integrated with Objective Structured Clinical Examination Module- A Teaching Tool in Physiology Department


Published: January 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/50640.15892
Shobitha Muthukrishnan, Shreelakshmi Ananthanarayanan, Harleen Kaur, Ashish Kumar Maurya, Monika Sharma

1. Professor, Department of Physiology, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India. 2. Apeejay School, Sector 16 A, Noida, Uttar Pradesh, India. 3. Assistant Professor, Department of Computer Science and Engineering, Jamia Hamdard, New Delhi, India. 4. Assistant Professor, Department of Computer Science and Engineering, Gautam Buddha University, Greater Noida, Uttar Pradesh, India. 5. Professor, Department of Paediatrics, Christian Medical College, Ludhiana, Punjab, India.

Correspondence Address :
Dr. Shobitha Muthukrishnan,
Professor, Department of Physiology, School of Medical Sciences and Research,
Sharda University, Greater Noida, Uttar Pradesh, India.
E-mail: drshobitha@gmail.com

Abstract

Introduction: Objective Structured Clinical Examination (OSCE) is designed to evaluate various learners’ skills. Formative feedback reinforces appropriate learning and contributes to correction of learner’s deficiencies. It was observed that the students in Clinical Physiology labs did not have direct observation and feedback on performance of clinical examination to address the gaps in knowledge and clinical skills.

Aim: To evaluate the perception of students and faculty on the effectiveness of structured feedback integrated with OSCE module for teaching clinical skills in Physiology Department.

Materials and Methods: A non randomised, intervention study was conducted on 100 phase I Bachelor of Medicine and Bachelor of Surgery (MBBS) students. Students were sensitised to OSCE topics. After taking written informed consent, initial OSCE sessions integrated with 1:1 feedback was conducted followed by OSCE sessions after 20 days in the same topics of clinical examination. OSCE scores were recorded. Feedback survey questionnaire to assess the perceptions of phase I MBBS students and retrospective pre-post assessment questionnaire was designed and administered. Student’s t-test, Likert scale analysis and Thematic analysis of the responses were done.

Results: Of the total 100 phase I MBBS students, males were 46 and females were 54 with a mean age of 20 and 19 years, respectively. Significant percentage of students got the opportunity to have constructive discussions of their strengths and weaknesses of learning clinical skills with the faculty (p-value=0.0246) and also felt satisfied with the structured points of the feedback given by the faculty (p-value=0.03181). There was significant increase in the OSCE scores of the students after the OSCE session integrated with feedback. Majority of the faculty felt satisfied with self assessment of student’s learning gaps and with the performance of clinical system examination by the students. Faculty confidence to give structured feedback to the students had improved.

Conclusion: It can be concluded that 1:1 structured feedback integrated with OSCE has significant educational impact and is an effective method for teaching clinical skills in physiology labs. It is one of the efficient ways to use OSCE checklists as an effective teaching resource.

Keywords

Clinical skill evaluation, Feedback questionnaire, Formative assessment

It is known that for the development of clinical expertise self-assessment alone is often inaccurate and insufficient (1),(2). Objective Structured Clinical Examination (OSCE) introduced in 1975 by Harden and Gleeson is a type of examination designed to test clinical skill performance and competence in a range of skills. Harden’s OSCE used actors and choreographed scenarios to evaluate the performance of professional behaviours which dramatically changed the assessment of professional competence (3).

The performance in both formative and summative assessment can be evaluated by OSCEs. Formative feedback is defined as “information communicated to the learner that is intended to modify his or her thinking or behaviour for the purpose of improving learning” (4). It is especially effective when information about previous performance is used to promote positive and desirable development (4). Studies have shown that feedback is also more effective when it is based on observed facts, focuses on tasks, specific, concise, and suggests areas for improvement (4),(5). Analysis of previous studies show that evaluation of clinical skills among medical students have been done during their clinical postings in various clinical setups (6),(7). Studies have evaluated student’s perception on OSCE as a learning tool and concluded that OSCE was perceived as an excellent learning tool for skill and attitude acquisition in medical education (8). There is paucity of similar studies to evaluate clinical skills using OSCE checklist integrated with feedback among phase I MBBS students. Previous study also suggests that OSCE is a feasible approach to assess a wide range of learning outcomes in different specialties and disciplines. It is for both formative and summative purposes in the different phases of education including the early and later years of the undergraduate medical curriculum (9). It is found that evaluation of educational effectiveness of clinical lab sessions in our present Physiology Department is needed. It was found that the faculty and students did not have direct observation and feedback on performance for clinical examination. Moreover, the gaps in knowledge and skills of students in clinical lab sessions were not being fully addressed in our Physiology Department.

Therefore, to address this gap, the present study aimed to evaluate the effectiveness of 1:1 structured feedback integrated with OSCE as a teaching tool for teaching clinical skills in Physiology Department. It was hypothesised that 1:1 structured feedback integrated with OSCE would be an effective teaching tool for teaching clinical skills to the phase I medical students in physiology clinical lab.

Material and Methods

A prospective, non randomised, interventional study was conducted on 100 phase I MBBS students, between March 2019 to November 2019 in Physiology Clinical lab, Hamdard Institute of Medical Sciences and Research (HIMSR), Jamia Hamdard, New Delhi, India. Permission of Institutional Ethics Committee with letter number 4/19 was obtained. Written Informed consent was obtained from phase I MBBS students.

Sample size calculation: Sample size was calculated by paired t-test with mean difference (-20.2178) and SD (3.0661), it was <6 subjects (10).

Eight physiology faculty members and three III year Master of Science (M.Sc) Medical Physiology postgraduate students were sensitised to uniformly teach clinical skills using OSCE checklist to 100 phase I MBBS students. OSCE teaching modules were peer expert validated.

Inclusion criteria: All the phase I MBBS students who were not exposed to any feedback process in clinical skill examination were included in the study.

Exclusion criteria: Students who did not attend the OSCE checklist based clinical examination teaching sessions were excluded from the study.

Self made feedback survey questionnaire mentioned in (Table/Fig 1) to assess the perceptions of phase I MBBS students on the feedback program were designed, peer expert validated and pilot tested on eight M.Sc physiology students not participating in the study. Topics for the OSCE sessions were identified and 10 OSCE stations for respiratory and cardiovascular system examination were finalised. OSCE checklists were used for examination of pulse, blood pressure, jugular venous pressure, tracheal position, chest auscultation for breath sounds, vocal fremitus, vocal resonance, apical impulse palpation and examination of bronchial breath sound (11). Student-teacher ratio in each OSCE station for feedback on performance was 1:1. Hundred MBBS students were sensitised to OSCE topics in physiology labs during the practical sessions.

Initial OSCE sessions integrated with feedback was conducted followed by OSCE sessions after 20 days in the same topics of respiratory and cardiovascular system examination. OSCE scores were recorded. Validated survey feedback questionnaire was administered to the students and faculty. Retrospective pre-post assessment questionnaire to rate the student’s response before and after the OSCE session was administered to the students. Scoring for the questionnaire was based on 5 point Likert scale where, 1=very poor, 2=poor, 3=average, 4=good and 5=excellent.

Statistical Analysis

Statistical Package for the Social Sciences software version 21.0 was used for analysis of the quantitative data. Likert scale analysis was done. Themes were identified for the responses to open-ended questions and thematic analysis was done. Paired t-test was done for comparison of OSCE scores.

Results

Out of total 100 phase I MBBS students, males were 46 with mean age±Standard Deviation (SD) of 20±1.3 years and females were 54 with mean age±SD being 19±1.1 years.

In the present study, Question (Q) 3 in (Table/Fig 1) found that 86% of the students felt satisfied with the structured points of the feedback given by the faculty (p-value=0.03181, significant for Q3). Q7 in (Table/Fig 1) found that 83% of the students also agreed that they felt satisfied that OSCE sessions followed by feedback has bridged their learning gaps.

Relevant themes identified in (Table/Fig 2) from student’s response were “better learning gap identification” and “improved confidence to perform the skills”.

(Table/Fig 3) shows that there was significant increase in the OSCE sores of phase I MBBS students after OSCE session integrated with 1:1 feedback.

(Table/Fig 4) shows significant increase in the Likert scale values of post feedback evaluations compared to that of the pre feedback evaluation.

Likert scale analysis of Q1 and Q2 in (Table/Fig 5) showed significant response of faculty for satisfactory assessment of student’s learning gaps and for the performance of clinical system examination by the students.

Relevant themes identified in (Table/Fig 6) from faculty response were “improved confidence to teach the clinical skills” and “to deliver effective feedback”.

Discussion

Effective teaching and learning of clinical skills to phase I MBBS students in our Physiology Department has been found to be a challenge to both the faculty and the students respectively. The present study has addressed this challenge.

The significant findings of this study are that the students felt satisfied about OSCE sessions followed by feedback and has bridged their learning gaps. Our study found that the students are confident of performing clinical system examination in future. Our study results are similar to study by Sadia SH et al., where OSCE’s educational value and assessed learning among seventy one postgraduate residents had a positive effect on learning competencies. Residents performed better in general communication and the mean score increased in general communication, in assessment, management and during global skill rating (12).

Similar findings by Brazeau C et al., showed that OSCE as a teaching tool proved to be efficient for students at the end of the third year family medicine clerkship, to observe a variety of doctor-patient interaction styles and to practice for future OSCE type examinations. It was found to improve their abilities to do a focused history and physical examination (13). Recent study by Ngim CF et al., found that OSCE feedback were highly valued by fourth year medical students in Malaysia who preferred to receive individualised enhanced written feedback and felt it was more beneficial (14).

Though feedback has been shown to be an important component for learning, a recent study by Karol DL and Pugh D found that many factors, such as the emotional reactions feedback evokes, may impact its effect. Only 29% of respondents in the study asserted that they had experienced emotional reactions like embarrassment and anxiousness to verbal feedback received in an OSCE setting and it negatively impacted subsequent OSCE performance (15). Therefore, it was concluded that feedback provided during an OSCE has the ability to evoke an emotional response in students and to potentially impact subsequent performance (15).

In the present study, structured constructive feedback was given to students and this has resulted in a positive educational impact among the students to perform better in the subsequent OSCE session. This was also reflected as significant improvement in the OSCE scores after the OSCE feedback sessions. Recent study by Alkhateeb NE et al., among fifth year medical students found that single formative OSCE does not necessarily lead to better performance in subsequent summative OSCE (16). The present study has overcome this limitation by conducting a second OSCE session after the initial OSCE with 1:1 feedback session and has found significant improvement in the OSCE scores.

Feedback questionnaire to assess the faculty perception for effectiveness of the OSCE sessions showed that they felt satisfied with the assessment of student’s learning gaps and with the performance of the students in clinical system examination. These results are similar to study by Brazeau C et al., where faculty members enjoyed this active teaching format involving clinical examination and found the process of giving feedback to the students educationally satisfying (13).

Thematic analysis of faculty perception also highlighted certain categories like “improved confidence in teaching clinical skills” and “improved confidence in giving structured feedback to students”. These findings are similar to previous study by Sulaiman ND et al., on Group Objective Structured Clinical Examination (GOSCE) introduced to medical students in years 1, 2, and 3. It showed that both students and clinical tutors valued the experience (17).

Feedback is one of the most important forms of interactions between the ‘teacher’ and the ‘learner’. However as phase I medical students are rarely directly observed and given feedback during their clinical lab sessions, there has been increased interest in the facilitation of feedback (18),(19). However, most of the previous studies have been done on medical students during their clinical postings in various clinical setups (20),(21). Studies on OSCE integrated with feedback are uncommon among phase I Indian medical students. Effectiveness of clinical lab sessions in Physiology Department during the initial phase of MBBS curriculum for phase I MBBS students has not been extensively evaluated. Therefore, the present study has addressed this gap and has exposed the phase I MBBS students to OSCE sessions integrated with feedback with promising positive educational impact. The present study found OSCE sessions followed by feedback to be beneficial to both the faculty and the students and therefore the teaching OSCE can be continued in future for physiology clinical labs and in hospital or clinical postings.

Limitation(s)

OSCE topics were limited to only cardiovascular and respiratory system due to paucity of time, faculty and resources. Authors did not investigate the relation between formative 1:1 OSCE with feedback and final summative or the university grades. The study focused only on the phase I MBBS students.

Conclusion

It can be concluded from the present study that structured 1:1 feedback integrated with OSCE is an effective method for teaching clinical skills in physiology lab. Present study demonstrated that both students and faculty viewed OSCE as a favourable opportunity to observe and reflect on their own performance. Therefore, utilising the existing OSCE checklist resources to transform the OSCE to a teaching tool for clinical skills has increased the educational impact among phase I medical students.

Acknowledgement

We thank the technicians and all staff of Physiology Department of HIMSR, Jamia Hamdard, New Delhi, India.

References

1.
Eva KW, Regehr G. Self-assessment in the health professions: a reformulation and research agenda. Academic medicine. 2005;80(10):S46-54. [crossref] [PubMed]
2.
Eva KW, Regehr G. "I'll never play professional football " and other fallacies of selfassessment. Journal of Continuing Education in the Health Professions. 2008;28(1):14-19. [crossref] [PubMed]
3.
Harden RM, Gleeson FA. Assessment of clinical competence using an objective structured clinical examination (OSCE). Medical Education. 1979;13(1):39-54. [crossref]
4.
Kogan JR, Conforti LN, Bernabeo EC, Durning SJ, Hauer KE, Holmboe ES. Faculty staff perceptions of feedback to residents after direct observation of clinical skills. Medical Education. 2012;46(2):201-15. [crossref] [PubMed]
5.
Shute VJ. Focus on formative feedback. Review of Educational Research. 2008;78(1):153-89. [crossref]
6.
Hasnain M, Connell KJ, Downing SM, Olthoff A, Yudkowsky R. Toward meaningful evaluation of clinical competence: the role of direct observation in clerkship ratings. Academic Medicine. 2004;79(10):S21-24. [crossref] [PubMed]
7.
Aeder L, Altshuler L, Kachur E, Barrett S, Hilfer A, Koepfer S, et al. The “Culture OSCE”-Introducing a formative assessment into a postgraduate program. Education for Health. 2007;20(1):11.
8.
Saroja C, Sathyasree C, Santa Kumari A, Padmini O. Student perception of OSCE as a learning tool in Osmania Medical College, Hyderabad, Telangana. Applied Physiology and Anatomy Digest. 2018;3(3):24-28.
9.
Patrício MF, Julião M, Fareleira F, Carneiro AV. Is the OSCE a feasible tool to assess competencies in undergraduate medical education? Medical Teacher. 2013;35(6):503-14. [crossref] [PubMed]
10.
Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian Journal of Psychological Medicine. 2013;35(2):121. [crossref] [PubMed]
11.
Objective Structured Clinical Examinations (OSCE) II: Developing Rating Scales and Checklists for OSCEs. 2019 National Board of Medical Examiners, 3750 Market Street Philadelphia, PA 19104.
12.
Sadia SH, Sultana SA, Rauf RA, Shaheen A, Shrif S, Waqar F. OSCE-a teaching tool. Pak J Med Health Sci. 2013;7(3):588-91.
13.
Brazeau C, Boyd L, Crosson J. Changing an existing OSCE to a teaching tool: the making of a teaching OSCE. Academic Medicine: Journal of the Association of American Medical Colleges. 2002;77(9):932-32. [crossref] [PubMed]
14.
Ngim CF, Fullerton PD, Ratnasingam V, Arasoo VJ, Dominic NA, Niap CP, et al. Feedback after OSCE: A comparison of face to face versus an enhanced written feedback. BMC Medical Education. 2021;21(1):01-09. [crossref] [PubMed]
15.
Karol DL, Pugh D. Potential of feedback during objective structured clinical examination to evoke an emotional response in medical students in Canada. Journal of Educational Evaluation for Health Professions. 2020;17. [crossref] [PubMed]
16.
Alkhateeb NE, Al-Dabbagh A, Ibrahim M, Al-Tawil NG. Effect of a formative objective structured clinical examination on the clinical performance of undergraduate medical students in a summative examination: a randomized controlled trial. Indian Pediatrics. 2019;56(9):745-48. [crossref] [PubMed]
17.
Sulaiman ND, Shorbagi SI, Abdalla NY, Daghistani MT, Mahmoud IE, Al-Moslih AM. Group OSCE (GOSCE) as a formative clinical assessment tool for pre-clerkship medical students at the University of Sharjah. Journal of Taibah University Medical Sciences. 2018;13(5):409-14. [crossref] [PubMed]
18.
Burgess A, Mellis C. Feedback and assessment for clinical placements: achieving the right balance. Advances in Medical Education and Practice. 2015;6:373. [crossref] [PubMed]
19.
Hattie J, Timperley H. The power of feedback. Review of Educational Research. 2007;77(1):81-112. [crossref]
20.
Bennett V, Furmedge D. The hidden value of a mock OSCE. The Clinical Teacher. (Print). 2013;10(6):407-08. [crossref] [PubMed]
21.
Perron NJ, Louis-Simonet M, Cerutti B, Pfarrwaller E, Sommer J, Nendaz M. The quality of feedback during formative OSCEs depends on the tutors’ profile. BMC Medical Education. 2016;16(1):01-08. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2022/50640.15892

Date of Submission: Jun 24, 2021
Date of Peer Review: Aug 23, 2021
Date of Acceptance: Oct 28, 2021
Date of Publishing: Jan 01, 2022

Author declaration:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 26, 2021
• Manual Googling: Oct 19, 2021
• iThenticate Software: Oct 26, 2021 (12%)

Etymology: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com