OSCE In Dentistry BLUE PRINT OSCE DESIGN MEI SYAFRIADI CORE TEAM KOMP 2 HPEQ KOLEGIUM DOKTER GIGI INDONESIA Introduction 1975 : OSCE was developed in Dundee, UK 1986 : World Federation for Medical Education: Meeting on Newer Developments in Assessing Clinical Competence 1992 : International Conference on Approach to the Assessment of Clinical Competence 1990 - now : OSCE become a routine. 1
Climbing the pyramid... OSCE In Dentistry Does Shows how Knows how Knows Performance assessment in vivo: Mini-CEx, Video, Audits.. Performance assessment in vitro: OSCE, SP-based test.. (Clinical) Context based tests: MCQ, essay type, oral.. Factual tests: MCQ, essay type, oral.. OSCE Format Purpose Advantages Writing principles Training observers Scoring considerations 2
OSCE In Dentistry PREPARATION 1. Membuat daftar Penyakit/departemen sesuai dengan SKDGI No Bidang Ilmu Jenis Penyakit 1 IKGA 1 Karies gigi anak, premature loss, trauma gigi, dll 2 KONSERVASI 1 Pulpitis Reversible/Irreversible, Trauma gigi (Fr Gigi) dll 3
2. Tentukan relevansi tiap jenis penyakit No Jenis Penyakit 1 Fraktur rahang Essensial (diagnoseterapi danpenanga nan komplikasi) relevansi Important (diagnosepenanganan I) Acceptable Diagnoserujuk) v Question able Hanya sekedar tahu) No 3. Menentukan jenis keterampilan sesuai dengan masing masing penyakit Type of Skill Brief Description 1 History Taking This may be with a volunteer, real patient 2 Physical Examination 3 Interpretation Skills 4 Procedural Skills 5 Communication Skills Which can involve demonstrating your skill on a patient, a normal volunteer or a mannequin Applying your knowledge to clinical finding, data, radiographs, etc Often use mannequins Interpersonal communication other than history taking. In standardized patient 6 Attitude A short oral examination in which the examiner will probe your attitudinal approach to a particular situation Dikutip dari : Dornan O neill; Core Clinical Skills OSCEs in Medicine, 2006 4
4. Menentukan level of Expected Ability level of expected Deskripsi/Penjelasan ability 1 Teori Mahasiswa menguasai dasar teori/pengetahuan yang meliputi prinsip, indikasi, kontra indikasi, resiko dan komplikasi tentang suatu tindakan atau ketrampilan klinis. 2 Melihat atau Mendemonstrasikan Mahasiswa menguasai dasar teori/pengetahuan tentang suatu tindakan atau ketrampilan klinis dan pernah melihat serta mampu mendemonstrasikan. 3 Melakukan atau Menerapkan dgn Pengawasan Mahasiswa menguasai dasar teori/pengetahuan tentang suatu tindakan atau ketrampilan klinis.dan dapat melakukan tindakan tersebut beberapa kali dengan bimbingan atau supervisi. 4 Rutin/Mandiri Mahasiswa menguasai dasar teori/pengetahuan tentang suatu tindakan atau ketrampilan klinis dan berpengalaman (rutin) dalam melakukan tindakan tersebut 5. Tentukan jenis keterampilan apa yang dibutuhkan untuk tiap penyakit dan level of ability Nama penyakit Jenis Keterampilan klinik level of expected ability Fraktur Rahang History taking 1 2 3 4 Physical Examination V Interpretation Skill V Procedural Skill V 5
6. MENENTUKAN TOOLS/INSTRUMEN PEMBELAJARAN KETERAMPILAN PURPOSE SUMBER DAYA HISTORY TAKING Riwayat kasus Pasien Standar (PS) PHYSICAL EXAM SKILL Pemeriksaan Klinis 1. Kondisi Umum & Extra Oral : Vital Sign, kelenjar, tonus otot, simetrisitas, deviasi, TMJ Pasien Standar (PS) INTERPRETATION SKILL PROCEDURAL SKILL COMMUNICATION, INFORMATION & EDUCATION 2. Intra Oral : Oral Hygiene, kelainan jar keras/lunak mulut Pemeriksaan penunjang Keterampilan Lab/klinik Profesionalism & etik Model/Manikin/Foto Klinis Model, Rekam Medik, Ro foto, Hasil Pemeriksaan lab Model, Rekam Medik, Instrumen Material Pasien Standar (PS), Model, Poster, Audio Visual 6
DESIGN Blueprinting Osce A Mapping of test items (psychomotoric items) to specific learning/course Ensures adequate sampling across subject area and skill domains Sampling Domain of Interest Test Sample Test Sample 7
STEPS Define/Select what is to be tested: Clinical problems at some Tasks for each problem Select the OSCE methods: Objectives Match the items skill to Spesific learning/course Methods: By tool Instrument/tools list By organ system By patient age By course located By department etc 8
Organ System-based Competence Categories CVS RS NB GI Repro MSS Endo/ Metab Haem/ Oncology GUS Head & Neck Special Sense Phsyciatry Case AMI (3B) TB Lung Febrile Conv. (SP) Diarrhea (pediatric) Obgyn (contrasepti on) Low Back Pain Thyroid (SP) DHF Grade 3-4 (adult) (SP) Urinary Retentio n (SP) Mild- Moderate Head Injury (SP) Hearing Dissorders (3A, depkes) Schizoprenia (SP) (3A, depkes) History Taking HT fever HT Thyroid Alloanamnesis Physical Exam Reflex Examination PE Thyroid GCS Assessment of hearing Tests & Procedures CPR Chest Xray IV line IM injection Suturing X-ray fracture IV line Catheteri zation Management Prescribe Communication & Patient Education Diet Counseling On malnutrition (peds) Breaking bad news (breast malignancy) Organ System-based Competence Categories Head And Neck Lymp honodi Bibir Gigi Rahang Jaringan Pendukung gigi Lidah Etc History Taking skill Mukokel Physical Exam Skill Lympha denitis Interpretation Skill Karies Procedural skill Periodontiti s Communication,Infor mation and Patient Education Fraktur 9
patient aged-based Competence Categories History Taking Physical Exam Tests and Procedures.. The Child CVS RS GI.. x The Elderly CVS RS GI x Course Located-System The Hospital Setting The Community Setting Competence Categories History Taking Physical Exam Tests and Procedures Communica tion Information Education CVS RS GI.. CVS RS GI x x x x x 10
Department/Division-based PSIKOMOTOR TAKING HISTORY PYSICAL EXAM SKILL INTERPRETATION SKILL PROCEDURAL SKILL COMMUNICATION & Patient EDUCATION Penyakit akibat trauma dan kecelakaan 1 2 3 4 5 6 7 8 1 Oral Medicine 2 Periodonsia 3 Bedah Mulut 4 Konservasi 5 Prostodonsia 6 Ortodonsia 7 Pedodonsia 8 IKGMP Catatan Oral Radiologi : integrated ke semua departemen UKDGI OSCE BLUE PRINT 11
DOMAIN GENERAL BLUE-PRINT for DENTISTRY COMPETENCY MCQ (%) OSCE (%) 1. Professionalism 10 10 2. Application of basic medical and dental sciences 3. General physical examination andstomatognatic system 4. Management of stomatognatic functions System 10 5 25 40 25 30 5. Oral and dental health 20 10 6. Management of dental practices 10 5 100 100 Varieties of OSCEs Patient-based Written task Clinical task Traditional OSCE SP-based test Station couplets Integral consultations.... 12
Key features of success in designing OSCEs Feasibility Congruence Feasibility Is it a reasonable task to expect the candidates to perform? Can the task be examined at an OSCE station? Can the task be performed in the time allowed? 13
Feasibility Is it a reasonable task to expect the candidates to perform? Is it authentic? Can the task be examined at an OSCE station? Match clinical situations as closely as possible Some tasks may require simulated patients Some tasks may require manikins Some tasks simply cannot be examined in this format Feasibility Can task be performed in time allowed? Pilot the stations to see if they are feasible Check equipment /helpers/practicalities 14
Congruence Is it testing what you want it to test? Station construct: describe what station is testing Congruence Ensure that all parts of station coordinate: Candidate instructions Marking schedule Examiner instructions Simulated patient instructions Equipment 15
16