OSCE AND OSPE, DIFFERENTIAL SACALE

OSCE AND OSPE, DIFFERENTIAL SACALE

1. SEMINAR ON OSCE/OSPE,DIFFERENTIAL SCALE SAKSHI RANA M.Sc NURSING

2. OSCE

3. (OSCE) INTRODUCTION: An OSCE is an; O  bjective S  tructured C  linical E  xamination

4. Contt.. Objective : examiners use a checklist for evaluating the trainees Structured : trainee see the same problem and performs the same tasks in the same time frame Clinical: the tasks are representative of those faced in real clinical situations Examination: a test check the person's knowledge or proficiency in a subject or skill.

5. Contt.. DEFINITION: OSCE is an assessment tool in which the components of clinical competence such as history taking, physical examination, simple procedures, interpretation of lab results, patient management problems, communication, attitude etc. are tested using agreed check lists and rotating the student round a number of stations some which have observers with cheek lists.

6. Contt.. OBJECTIVES: The aim in the examination is to produce a profile for each candidate rather than a single composite mark. A candidate, For example, may be competent in physical examination techniques, but have an unsatisfactory attitude and may be lacking in interpersonal skills .

7. Contt.. The examination tests a wide range of skills thus greatly reducing the sampling error. This very significantly improves the reliability of the examination. All students face the same tasks. Candidates see a number of examiners in the course of the examination

8. Contt.. PURPOSES OF OSCE: Variability Defects in competencies examined Difficulties in conducting Exams

9. Contt.. PRINCIPLE: Skill to be tested is given in form of a specific question To be answered in 4-5 minutes Each question is a station or each question (station) a check list is prepared in advance Check list prepared by breaking the skill to be tested into its vital components and precautions to be observed

10. Contt.. METHODOLOGY : The OSCE examination consists of about 15-20 stations each of which requires about 4-5 minutes of time . All stations should be capable of being completed in the same time. in which each candidate is examined on a one-to-one basis with one or two impartial examiner. The students are rotated through all stations and have to move to the next station at the signal.

11. Contt.. Example of a procedure station ; Task - Examine the scrotal swelling in patient. Points in the check list: Does he explain to the patient what he is going to do? Does he take permission ? Does he provide a screen ? Does he ask the patient to expose the whole abdomen and genitalia ? Does he examine both sides of the scrotum?

12. Contt.. 6. Does he take care not to cause discomfort? 7. Does he palpate the spermatic cord? 8. Does he palpate the abdomen (for lymphnodes in case it is a patient with a testicular tumour ) 9. Does he palpate the supraclavicular nodes? 10. Does he thank the patient?

13. Contt..

14. Contt.. ADVANTAGES: All components of clinical Exams are assessed so more Valid examination Used as summative as well formative Can be used with larger number of students Components of clinical Skills& standards of competencies are predetermined So Objectivity & Reliability is higher

15. Contt.. Provides unique programmatic evaluation Objectivity and validity are highly ensured in OSCE A wide range and variety of facts can be tested at a time. Contains detailed feedback for students and teachers.

16. Contt.. DISADVANTAGES: Knowledge and skills are tested in compartments & not tested in ability to look at the Pt. as a whole, So long case may also needed The OSCE may be demanding for both examiners and patients More time in setting it up

17. Contt.. Shortage of examiners Might be quite distressing to the student Expensive. Takes long time to construct a case and a scoring checklist.

18. ENTRY STATION 1 STATION 2 STATION 3 STATION 4 STATION 6 STATION 7 STATION 9 STATION 15 STATION 14 STATION 13 STATION 12 STATION 11 STATION 10 STATION 9 STATION 5 EXIT EXAMPLE OF OSCE

19. OSPE

20. (OSPE) INTRODUCTION: An OSPE is an: O  bjective S  tructured P  ractical E  xamination

21. Contt.. DEFINITION : Objective structured practical examination (OSPE ) is a new pattern of practical examination , in which each component of clinical competence is tested uniformly and objectively for all the students who are taking up a practical examination at a given place.

22. Contt.. FEATURES: The stations are short i.e. the task at each station Does not exceed 4 – 5 minutes. The stations are numerous ranging from 12 – 20 stations as desired. The stations are very highly focused.

23. Contt.. Pre-structured check list / marking schemes are used. Scoring is objective, since standards of competence are pretested and agreed check lists, used for scoring. Simulations / models can be used for acute cases. There is reduced examiner / patient input thus increasing the validity of the examination 

24. Contt.. METHODOLOGY : The OSPE examination consists of about 15-20 stations each of which requires about 4-5 minutes of time. All stations should be capable of being completed in the same time. in which each candidate is examined on a one-to-one basis with one or two impartial examiner.

25. Contt.. Example of an OSPE Task - Examine the specimen of urine provided for proteins. Check list Does he take a urine sample to 2/3 level in the test tube? Does he boil upper 1/3 of the column? Does he add 2% acetic acid drop by drop? Does he compare change in the top layer with the bottom layer of urine?

26. Contt..

27. Contt.. ADVANTAGES : Large samples of students’ clinical abilities can be assessed . The examiner can specify in advance what has to be assessed. The use of checklist encourages a more objective assessment. Each student has a number of examiners. All students have the same, nearly identical patients.

28. Contt.. DISADVANTAGES: It's very resource intensive. Long time planning is required. care must be taken to organize the stations. External examiners need to be convinced/ (trained will be more appropriate) for the process. Proper look up for routine entries like roll. no. etc. Examines in components, not holistic. Observer fatigue.

29. ENTRY STATION 1 STATION 2 STATION 3 STATION 4 STATION 6 STATION 7 STATION 9 STATION 15 STATION 14 STATION 13 STATION 12 STATION 11 STATION 10 STATION 9 STATION 5 EXIT EXAMPLE OF OSPE

30. DIFFERENTIAL SCALE

31. DIFFERENTIAL SCALE INTRODUCTION: Semantic differential scale or the S.D. scale developed by Charles E. Osgood , G.J. Suci and P.H. Tannenbaum (1957), is an attempt to measure the psychological meanings of an object to an individual surveys using Semantic Differential Scale is the most reliable way to get information on people’s emotional attitude towards a topic of interest.

32. Contt.. This scaling consists of a set of bipolar rating scales, usually of 7 points, by which one or more respondents rate one or more concepts on each scale item. 

33. Contt.. DEFINITION: The   Semantic Differential Scale  is a seven-point rating scale used to derive the respondent’s attitude towards the given object or event  by asking him to select an appropriate position on a scale between two bipolar adjectives (such as  “warm”  or  “cold” ,  “powerful”  or  “weak” , etc.)

34. Contt..

35. Contt.. HISTORY OF SEMANTIC DIFFERENTIAL: Semantic Differential was developed by C.E. Osgood in 1957 precisely to measure the connotative meaning of cultural objects. The use of semantic differential questions have been seen in various social sciences, market research, and therapy.

36. Contt.. Osgood performed research on large collections of semantic differential scales and found that three dimensions of affective meaning were universal across cultures, despite those cultures’ linguistic differences: Evaluation : pairs like ‘good-bad.’ Potency : pairs such as ‘powerful-weak.’ Activity : includes pairs like ‘active-passive’.

37. Contt..

38. Contt.. FACTORS OF EVALUATION, POTENCY, AND ACTIVITY : Osgood and his colleagues performed a  factor analysis  of large collections of semantic differential scales and found three recurring attitudes that people use to evaluate words and phrases: evaluation, potency, and activity. Evaluation loads highest on the adjective pair 'good-bad'. The 'strong-weak' adjective pair defines the potency factor. Adjective pair 'active-passive' defines the activity factor.

39. Contt.. METHODOLOGY: (1) Bipolar adjective scales are a simple, economical means for obtaining data on people's reactions. With adaptations, such scales can be used with adults or children, persons from all walks of life, and persons from any culture. (2) Ratings on bipolar adjective scales tend to be correlated, and three basic dimensions of response account for most of the co-variation in ratings. The three dimensions, which have been labeled Evaluation, Potency, and Activity (EPA), have been verified and replicated in an impressive variety of studies.

40. Contt.. 3) Some adjective scales are almost pure measures of the EPA dimensions; for example, good-bad for Evaluation, powerful-powerless for Potency, and fast-slow for Activity. Using a few pure scales of this sort, one can obtain, with considerable economy, reliable measures of a person's overall response to something. Typically, a concept is rated on several pure scales associated with a single dimension, and the results are averaged to provide a single factor score for each dimension. Measurements of a concept on the EPA dimensions are referred to as the concept's profile.

41. Contt.. (4) EPA measurements are appropriate when one is interested in affective responses. The EPA system is notable for being a multi-variate approach to affect measurement. It is also a generalized approach, applicable to any concept or stimulus, and thus it permits comparisons of affective reactions on widely disparate things. EPA ratings have been obtained for hundreds of word concepts, for stories and poems, for social roles and stereotypes, for colors, sounds, shapes, and for individual persons.

42. Contt.. USAGE: The semantic differential is today one of the most widely used scales used in the measurement of attitudes . One of the reasons is the versatility of the items. The bipolar adjective pairs can be used for a wide variety of subjects, and as such the scale is nicknamed "the ever ready battery” of the attitude researcher.

43. Contt..   ADVANTAGES : Theory suggests that the semantic differential is one of the most appropriate techniques to assess the intensity and direction of the meaning of concepts, opinions, and attitudes. The advantages of the semantic differential are also backed by empirical results. the semantic differential has been demonstrated to function effectively as a short-form scale format to reduce survey completion time . Elements of a semantic differential include the concept to be measured, a negative polar, a positive polar, and a scale connecting both polar.

44. Contt.. The primary advantage of semantic differential scale is that it is easy to understand the scale and rate correctly and its popularity makes it very familiar with responders. This makes information collected very reliable. Another advantage is in the versatility of semantic differential scale type questions, they have been successfully used in satisfaction scientific behavioral analysis.

45. Contt.. DISADVANTAGES : Semantic differential suffers from a lack of standardization . The numbers of divisions on the scale are a problem. If too few divisions are used, the scale is crude and lacks meaning; if too many are used, the scale goes beyond the ability of most people to discriminate.

46. Contt.. In this we use ranges there is no one correct answer, which makes it difficult to identify the knowledge level of the responder. So, some preparatory questions to categorize the responder into knowledge levels is recommended. Identifying the correct number of points on the scale can be tricky and highly dependent on question type. Just remember that too few points on the scale means you may not capture the emotional range felt by the responder, while too many points might seek information that is not there.