OSCE (objective structured clinical examination) is a common form of clinical examination for health professions all over the world. OSCE is a station based examination format, where students move from station to station and solve assignments to showcase their skills in communication, examination og practical prosedures. The curriculum of the exam is decided in advance through blueprints for OSCE; the assignments are structured and evaluated in accordance with quality assurance protocols; and standardized patients or actors make the assignments more authentic.

Why?

At the Faculty of Medicine and Health Sciences (NTNU), OSCE is established as form of examination at the medical curriculum for students in their first, third and fourth year. All students in the same year are evaluated during the same day. This ensures that OSCE is an objective and fair examination. 

The end-of-semester exam is not just a quality control of the students, but also an opportunity to learn. This especially rings true if the students are allowed to practice on authentic OSCE cases prior to the actual exam, and are given valuable feedback on how good or bad their performance was.

Modern medicine requires doctors to be skilled at acquiring new knowledge, in order to be prepared for the rapid development of their field. Medical students should be given the opportunity to learn through active means of learning, that enables them to be adaptable students for the rest of their lives. Experiental learning enables the students to set goals for themselves, gain knowledge, test this new knowledge, reflect upon what they have learned and then set new goals. 

Learning is also done well with colleagues on the same level, and valuable feedback often comes from someone who understand just what is needed. Fellow students are able to give good feedback. Giving and recieving feedback from someone at the same level is both effective and has the potensial to raise the self-esteem of everyone involved.

Formative OSCE driven by medical students, for medical students, or driven by residents for residents, is in use in many countries. We wish to further develop this and invite the medical students to make OSCE assignments, organize formative OSCE and give each other structured feedback. 

We will begin testing student driven formative OSCE, with exercise writing and feedback from fellow students from 2018 to 2020. The project's first phase begins fall of 2018, with a pilot project that will be conducted in collaboration with master student Marie Thoresen at Harvard Medical School, Boston, USA.

During summer of 2018, upcoming 4th year medical students will be contacted with more information on the project. A group of 20 IIC-students will be recruited to make a pilot of the student driven OSCE. The students will be taught to write OSCE exercises and to give high quality structured feedback by participating in two courses, two hours each, taught by project leader Marie Thoresen. Following this, the students will make OSCE exercises and organize a formative OSCE in early november 2018, where these exercises will be tested. The way the students learn, what they learn and how the project works will be analyzed continuously.

After the pilot phase, the project will be evaluated, improved and then gradually offered to all medical students of NTNU with OSCE as part of their exam. 

Anderson, P. A. (2012). Giving feedback on clinical skills: are we starving our young? J Grad Med Educ, 4(2), 154-158. doi:10.4300/JGME-D-11-000295.1

Armstrong, E., & Parsa-Parsi, R. (2005). How can physicians' learning styles drive educational planning? Acad Med, 80(7), 680-684. 

Burgess, A., Clark, T., Chapman, R., & Mellis, C. (2013). Senior medical students as peer examiners in an OSCE. Med Teach, 35(1), 58-62. doi:10.3109/0142159x.2012.731101

Chisnall, B., Vince, T., Hall, S., & Tribe, R. (2015). Evaluation of outcomes of a formative objective structured clinical examination for second-year UK medical students. Int J Med Educ, 6, 76-83. doi:10.5116/ijme.5572.a534

Cushing, A., Abbott, S., Lothian, D., Hall, A., & Westwood, O. M. (2011). Peer feedback as an aid to learning--what do we want? Feedback. When do we want it? Now! Med Teach, 33(2), e105-112. doi:10.3109/0142159X.2011.542522

Cutrer, W. B., Miller, B., Pusic, M. V., Mejicano, G., Mangrulkar, R. S., Gruppen, L. D., . . . Moore, D. E., Jr. (2017). Fostering the Development of Master Adaptive Learners: A Conceptual Model to Guide Skill Acquisition in Medical Education. Acad Med, 92(1), 70-75. doi:10.1097/ACM.0000000000001323

Khan, K. Z., Ramachandran, S., Gaunt, K., & Pushkar, P. (2013). The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part I: an historical and theoretical perspective. Med Teach, 35(9), e1437-1446. doi:10.3109/0142159X.2013.818634

Khan, R., Payne, M. W. C., & Chahine, S. (2017). Peer assessment in the objective structured clinical examination: A scoping review. Med Teach, 39(7), 745-756. doi:10.1080/0142159x.2017.1309375

Kolb, David A. (1984). Experiential learning : experience as the source of learning and development. Englewood Cliffs, N.J.

Konopasek, L., Norcini, J., & Krupat, E. (2016). Focusing on the Formative: Building an Assessment System Aimed at Student Growth and Development. Acad Med, 91(11), 1492-1497. doi:10.1097/ACM.0000000000001171

Larsen, D. P., Butler, A. C., & Roediger, H. L., 3rd. (2008). Test-enhanced learning in medical education. Med Educ, 42(10), 959-966. doi:10.1111/j.1365-2923.2008.03124.x

Lee, C. B., Madrazo, L., Khan, U., Thangarasa, T., McConnell, M., & Khamisa, K. (2018). A student-initiated objective structured clinical examination as a sustainable cost-effective learning experience. Med Educ Online, 23(1), 1440111. doi:10.1080/10872981.2018.1440111

Lefroy, J., Watling, C., Teunissen, P. W., & Brand, P. (2015). Guidelines: the do's, don'ts and don't knows of feedback for clinical education. Perspect Med Educ, 4(6), 284-299. doi:10.1007/s40037-015-0231-7
Moineau, G., Power, B., Pion, A. M., Wood, T. J., & Humphrey-Murto, S. (2011). Comparison of student examiner to faculty examiner scoring and feedback in an OSCE. Med Educ, 45(2), 183-191. doi:10.1111/j.1365-2923.2010.03800.x

Nicol, David J., & Macfarlane‐Dick, Debra. (2006). Formative assessment and self‐regulated learning: a model and seven principles of good feedback practice. Studies in Higher Education, 31(2), 199-218. doi:10.1080/03075070600572090

Pugh, D., Desjardins, I., & Eva, K. (2018). How do formative objective structured clinical examinations drive learning? Analysis of residents' perceptions. Med Teach, 40(1), 45-52. doi:10.1080/0142159X.2017.1388502