Introducing formative assessment during Family Medicine clerkship to improve students' clinical skills

Formative objective structured clinical examination (OSCE) provides an experiential learning activity where students can receive feedback on their clinical skills. Feedback can have a very powerful effect on learning. The aim of the change project was to introduce formative assessment of clinical skills during the clerkship training using OSCE.A pilot formative OSCE was implemented on 17 December 2014.Twenty-five students, nine clinical tutors, and one simulated patient participated in the formative OSCE. The formative OSCE included 10 stations. Students rotated around the stations in groups of two or three. One student performed a clinical task in seven minutes while being observed by the clinical tutor and peers, then a five-minute structured feedback followed. The stations exposed students to different clinical skills including breaking bad news, smoking cessation counseling, explaining insulin therapy, explaining investigation results, prescription writing, history taking, and physical examination. Evaluation was through surveys and interviews with participants. Results obtained from the students’ surveys and the focused groups were consistent. Students appreciated the feedback provided during the formative OSCE. A pre-OSCE and post-OSCE confidence level survey showed a significant increase in students overall confidence on the performed clinical skills. In conclusion, formative OSCE provided a structured learning activity that was appreciated by the students and had increased their perceived confidence on the performed clinical skills.