BOSTON UNIVERSITY INSTRUCTIONAL INNOVATION CONFERENCE

Friday, March 2, 2012

Presented By: 

Mark S. Ferriero, BA, DDS, MAGDClinical Associate Professor

Boston University Henry M. Goldman School of Dental Medicine

Department of General Dentistry ferriero@bu.edu

Purely objective exams (e.g. case-based or context-free MCQs) have been a constant, a staple in education for decades. In clinically-

oriented educational environments (e.g. medical, dental, pharmacy, PT),

additional/adjunct testing styles are quite beneficial, even necessary for success. OSCE (Objective Structured Clinical Examination)

testing, in one form or another, has been used in medical school education worldwide for over

100 years. In dental education, this style of exam has been used predominantly in the

study of Gross Anatomy. Students are asked questions based on visual cues or markers on human cadavers (e.g. "Identify this nerve." or

"What is the insertion point of this muscle?"). In recent years, dental education has benefited

greatly from the OSCE.

By way of definition, style and design explanation, example, and Q & A, I propose to enlighten/inspire other educators in this testing medium. There is much to be learned through correctly processing

and responding, in a timed fashion, to simple visual, multi-media, and media-like

cues/information/stimuli (e.g. an X-ray, a song, a phlebotomy video, a painting, National Licensure

Testing question). I have been using the OSCE for over 6 years in my Pre-Doctoral Occlusion course in

the dental school with much positive feedback. Students' resultant clinical comprehension and

NDBE (National Dental Board Examination) success in this discipline have greatly improved. The

National Dental Examining Board of Canada (NDEB) utilizes the OSCE as 50% of its licensure

examination. OSCEs can be administered & evaluated on the web (e.g. Blackboard 8)

Candidates are assessed using exactly the same stations or cues with the same marking

scheme. Candidates get marks/points for each step that they perform/answer correctly. This makes the assessment of

clinical skills more objective rather than subjective.

Stations/cues have specific tasks. Where simulated

patients are used, detailed scripts are provided to all

candidates, including emotional data. Instructions are carefully written/spoken to ensure that candidates are given specific

tasks to complete or questions to answer. The OSCE is

carefully designed to include all elements of the curriculum.

An OSCE is designed to apply clinical and

theoretical knowledge. Where theoretical

knowledge is required, questions are standardized.

An OSCE is a modern type of examination often used in the health sciences (e.g. medicine, chiropractic, PT, radiography,

nursing, pharmacy, dentistry) to test clinical skill performance and

competence in skills such as communication, clinical

examination, medical procedures, prescription-writing, manipulation techniques, and interpretation of

results.

DEFINITION:DEFINITION:

6

¹ONLY 5% of Pharmacy Students in ¹ONLY 5% of Pharmacy Students in the the

USA take OSCE Prep Study Courses!USA take OSCE Prep Study Courses!

An OSCEOSCE comprises a series of short, timed stations or visual cues.

Candidates respond objectively. All candidates take the same exam. This

is an improvement over traditional exams because stations are standardized enabling fairer

comparison. Complex procedures, techniques, etc. can be assessed without endangering patients (if

applicable) or requiring the use of multiple cues.

²Which of the following is the most likely anatomical structure/diagnosis for the

radiographic entity shown?

A. Normal toothB. Developing root apex

C. HypercementosisD. Tooth fracture

E. Periapical cemento-osseous dysplasiaF. Complex Odontoma

G. Dens invaginatus/dens-in-denteH. Ameloblastoma

WHAT MANDIBULAR POSITION IS

SEEN IN THESE FULL DENTURES?

1. IDENTIFY THIS PIECE OF EQUIPMENT.2. LIST 3 OF ITS USES.

ADEAADEA

2328

1746 1744

1603

1166

1018

553 548 537508 507

435 428

0

500

1000

1500

2000

2500

Case-BasedMCQ

Context-Free MCQ

DailyClinicEvals

ClinicalCompExams

Tech LabSkill Evals

StudentSelf-

Assess

Essays OralExams

Long-TermClinicEvals

ProceduralUnits

ResearchProjects

Computer-BasedSims

OSCEs

ASSESSMENT METHODS

All indicators point to the validity, efficacy, and even necessity of the

OSCE as a critically important, versatile evaluation tool in clinical sciences & other arenas of education. An OSCE

comprises 50% of the National Dental & Pharmacy Boards of Canada. The State of Minnesota now accepts the NDEB of

Canada for dental licensure. Nonetheless, OSCEs seem mysterious

and under-utilized. Competency Based Education (CBE), as indicated by the ADEA, is predicated on their stylized

and integrated use.