• Rev Med Interne · Oct 2022

    [Contribution and limits of "OSCE", "long-case" and "global end-of-placement marking" as end-of-rotation assessment methods. Experience from two internal medicine wards].

    • A Régent, J-B Arlet, G Cheminet, J Pouchot, L Mouthon, and C Le Jeunne.
    • Université de Paris, 15, rue de l'école de médecine, 75006 Paris, France; Service de médecine interne, centre de référence maladies auto-immunes et systémiques rares d'ile de France, hôpital Cochin, AP-HP-CUP, 75014 Paris, France. Electronic address: alexis.regent@aphp.fr.
    • Rev Med Interne. 2022 Oct 1; 43 (10): 581-588.

    IntroductionDuring placements, there is an opportunity to learn clinical skills and to assess their application. However, it represents two different goals. The validity of an end-of-placement assessment is questionable, as the medical competency is contextual. We decided to evaluate the contribution and limits of different assessment modalities as an end-of-placement assessment.Material And MethodsInternal medicine clerks were assessed using the Mini-Cex grid by a structured objective clinical examination (OSCE), a long-case clinical examination (LCE) and a global end-of-placement marking (GEPM). Following these evaluations, students and teachers fulfilled an open questionnaire.ResultsIn 2021, 41 students and 16 teachers participated in the study. Physical examination was evaluated in 0%, 97% et 76% of cases during OSCE, LCE and GEPM, respectively; teaching skills were assessed for 100, 42 et 49% of students in OSCE, LCE and GEPM, respectively. As compared to OSCE, there was a perceived superiority of LCE regarding its formative value (P=0.07 and P=0.03) and its summative value (P=0.0007 and P=0.02), for students and teachers, respectively. Qualitative analysis highlights the breadth of clinical skills that could be assessed during OSCE stations. Integration into a team was an additional skill that could specifically be assessed during GEPM. GEPM could also take into account the progress made during placement.ConclusionDespite its subjectivity, LCE seemed to be the preferred modality for an end-of-rotation assessment.Copyright © 2022 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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