What do we know about Objective Structured Clinical Examination in Sport and Exercise Medicine? A scoping review
DOI:
https://doi.org/10.36834/cmej.77841Abstract
Background and objectives: Despite the importance of the Objective Structured Clinical Examination (OSCE) in Sport and Exercise Medicine, the literature on the topic is fragmented and has been poorly developed. The goal of this review was to map current knowledge about how the OSCE is used in Sport and Exercise Medicine, and to identify knowledge gaps for future research.
Method: The authors conducted a scoping review. They searched PubMed and Scopus for articles using key terms related to 'OSCE' and 'sport medicine' with no limit on search start date and up to July 2022. Retrieved records were imported, abstracts were screened, and full-text articles were reviewed. A forward and backward citation tracking was conducted. Data was extracted and a qualitative meta-summary of the studies was conducted.
Results: A total of 469 records were screened, and 22 studies were included. The objectives of the studies included using OSCEs to assess knowledge/skills after a training program (n = 11), to assess an intervention (n = 8), and to assess and improve the OSCE itself (n = 3). Thirteen studies reported validity and/or reliability of the OSCE.
Conclusion: Despite the widespread use of OSCEs in the examination of Sport and Exercise Medicine trainees, only a handful of scholarly works have been published. More research is needed to support the use of OSCE in Sport and Exercise Medicine for its initial purpose. We highlight avenues for future research such as assessing the need for a deeper exploration of the relationship between candidate characteristics and OSCE scores.
References
Kreptul D, Thomas R. Family medicine resident OSCEs: a systematic review. Education for primary care: an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors. Nov 2016;27(6):471-477. https://doi.org/10.1080/14739879.2016.1205835
Lafave M, Mohtadi N, Chan D. Musculoskeletal injury evaluation standards for different disciplines. Athletic Therapy Today. 2012;17(2):21-24. https://doi.org/10.1123/ijatt.17.2.21 DOI: https://doi.org/10.1123/ijatt.17.2.21
Martinez J, Harris C, Jalali C, Tung J, Meyer R. Using peer-assisted learning to teach and evaluate residents' musculoskeletal skills. Med Educ Online. 2015;20(1)27255. https://doi.org/10.3402/meo.v20.27255 DOI: https://doi.org/10.3402/meo.v20.27255
Harden RM. Revisiting 'Assessment of clinical competence using an objective structured clinical examination (OSCE)' Med Educ. 2016;50(4):376-379. https://doi.org/10.1111/medu.12801 DOI: https://doi.org/10.1111/medu.12801
Hodges B, Hollenberg E, McNaughton N, Hanson M, Regehr G. The psychiatry OSCE: a 20-year retrospective. Acad Psychiatry. 2014;38(1):26-34. https://doi.org/10.1007/s40596-013-0012-8 DOI: https://doi.org/10.1007/s40596-013-0012-8
Zayyan M. Objective structured clinical examination: the assessment of choice. Oman Med J. 2011;26(4):219. https://doi.org/10.5001/omj.2011.55 DOI: https://doi.org/10.5001/omj.2011.55
Sloan DA, Donnelly MB, Schwartz RW, Strodel WE. The objective structured clinical examination: the new gold standard for evaluating postgraduate clinical performance. Annals Surg. 1995;222(6):735-742. https://doi.org/10.1097/00000658-199512000-00007 DOI: https://doi.org/10.1097/00000658-199512000-00007
Kreptul D, Thomas R. Family medicine resident OSCEs: a systematic review. Educ Prim Care. 2016;27(6):471-477. https://doi.org/10.1080/14739879.2016.1205835 DOI: https://doi.org/10.1080/14739879.2016.1205835
Hodges B, Hanson M, McNaughton N, Regehr G. Creating, monitoring, and improving a psychiatry OSCE. Acad Psychiatry. 2002;26(3):134-161. https://doi.org/10.1176/appi.ap.26.3.134 DOI: https://doi.org/10.1176/appi.ap.26.3.134
Casey PM, Goepfert AR, Espey EL, et al. To the point: reviews in medical education-the Objective Structured Clinical Examination. Amer J Obstetric Gynecol. 2009;200(1):25-34. https://doi.org/10.1016/j.ajog.2008.09.878 DOI: https://doi.org/10.1016/j.ajog.2008.09.878
McNaughton N, Ravitz P, Wadell A, Hodges BD. Psychiatric education and simulation: A review of the literature. Can J Psychiatry. 2008;53(2):85-93. https://doi.org/10.1177/070674370805300203 DOI: https://doi.org/10.1177/070674370805300203
Dwyer T, Glover Takahashi S, Kennedy Hynes M, et al. How to assess communication, professionalism, collaboration and the other intrinsic CanMEDS roles in orthopedic residents: use of an objective structured clinical examination (OSCE). Can J Surg. 2014;57(4):230-6. https://doi.org/10.1503/cjs.018813 DOI: https://doi.org/10.1503/cjs.018813
Safai P. A Critical Analysis of the Development of Sport Medicine in Canada, 1955–80. International Review for the Sociology of Sport. 2007;42(3):321-341. https://doi.org/10.1177/1012690207088115 DOI: https://doi.org/10.1177/1012690207088115
Wesner M. What is a sport and exercise medicine physician? Can Fam Phys. 2017.
The Royal College of Physicians and Surgeons of Canada. Competency training requirements for the area of focused competence in sport and exercise medicine. http://www.royalcollege.ca/rcsite/documents/ibd/sport-exercise-medicine-ctr-e [Accessed Jun 14, 2020].
Pigozzi F. Specialisation in sports medicine: the state of the sport medicine specialty training core curriculum in the European Union. Brit Assoc Sport Excercise Med. 2009. https://doi.org/10.1136/bjsm.2008.055350 DOI: https://doi.org/10.1136/bjsm.2008.055350
Orchard JJ, Orchard JW, Driscoll TR. Comparison of sports medicine, public health and exercise promotion between bidding countries for the FIFA World Cup in 2018. Brit J Sports Med. 2010;44(9):631-636. https://doi.org/10.1136/bjsm.2010.073551 DOI: https://doi.org/10.1136/bjsm.2010.073551
Humphries D, Jaques R, Dijkstra HP. A Delphi developed syllabus for the medical specialty of sport and exercise medicine. Brit J Sports Med. 2018;52(8):490-492. https://doi.org/10.1136/bjsports-2017-098477 DOI: https://doi.org/10.1136/bjsports-2017-098477
CASEM/ACMSE. Sport and Exercise Medicine Diploma Exam., https://casem-acmse.org/education/diploma-in-sem/ [Accessed Jun 12, 2020].
Mohtadi NGH, Harasym PH, Pipe AL, Strother RT, Mah AF. Using an objective structured clinical examination to evaluate competency in sport medicine. Clin J Sport Med. 1995;5(2):82-85. https://doi.org/10.1097/00042752-199504000-00002 DOI: https://doi.org/10.1097/00042752-199504000-00002
Harasym P, Mohtadi N, Henningsmoen H. Construct validity of “high stakes” OSCE scores. Adv Med Educ. Springer; 1997:443-445. https://doi.org/10.1007/978-94-011-4886-3_134 DOI: https://doi.org/10.1007/978-94-011-4886-3_134
Arksey H, O'malley L. Scoping studies: towards a methodological framework. Intern J Soc Res Meth. 2005;8(1):19-32. https://doi.org/10.1080/1364557032000119616 DOI: https://doi.org/10.1080/1364557032000119616
Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(1):69. https://doi.org/10.1186/1748-5908-5-69 DOI: https://doi.org/10.1186/1748-5908-5-69
Morris M, Boruff JT, Gore GC. Scoping reviews: establishing the role of the librarian. JMLA. 2016;104(4):346. https://doi.org/10.3163/1536-5050.104.4.020 DOI: https://doi.org/10.3163/1536-5050.104.4.020
Peters MDJ, Marnie C, Tricco AC, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis. 2020;18(10):2119-2126. https://doi.org/10.11124/jbies-20-00167 DOI: https://doi.org/10.11124/JBIES-20-00167
Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Annals Intern Med. 2018;169(7):467-473. https://doi.org/10.7326/M18-0850 DOI: https://doi.org/10.7326/M18-0850
Sandelowski M, Barroso J, Voils CI. Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings. Res Nurs health. 2007;30(1):99-111. https://doi.org/10.1002/nur.20176 DOI: https://doi.org/10.1002/nur.20176
Cook DA, Beckman TJ. Current concepts in validity and reliability for psychometric instruments: theory and application. Amer J Med. 2006;119(2):166.e7-166.e16. https://doi.org/10.1016/j.amjmed.2005.10.036 DOI: https://doi.org/10.1016/j.amjmed.2005.10.036
Dwyer T, Theodoropoulos J, Herold J, et al. Assessing competence of orthopaedic residents: the reliability and validity of an objective structured clinical examination after a sports medicine rotation. J Bone Joint Surg - Series A. 2013;95(22):e1771-e1779. https://doi.org/10.2106/JBJS.M.00148 DOI: https://doi.org/10.2106/JBJS.M.00148
Dwyer T, Wright S, Kulasegaram K, et al. Competency-based medical education can both junior residents and senior residents achieve: competence after a sports medicine training module? J Bone Joint Surg - Amer Vol. 2015;97(23):1985-1991. https://doi.org/10.2106/JBJS.O.00252 DOI: https://doi.org/10.2106/JBJS.O.00252
Dwyer T, Slade Shantz J, Kulasegaram KM, et al. Use of an objective structured assessment of technical skill after a sports medicine rotation. J Arthroscopy. 2016;32(12):2572-2581.e3. https://doi.org/10.1016/j.arthro.2016.05.037 DOI: https://doi.org/10.1016/j.arthro.2016.05.037
Dwyer T, Chahal J, Murnaghan L, et al. Development of a certification examination for orthopedic sports medicine fellows. Can J Surg. 2020;63(2):E110. https://doi.org/10.1503/cjs.015418 DOI: https://doi.org/10.1503/cjs.015418
Battistone MJ, Barker AM, Grotzke MP, et al. Effectiveness of an interprofessional and multidisciplinary musculoskeletal training program. J Grad Med Ed. 2016;8(3):398-404. https://doi.org/10.4300/JGME-D-15-00391.1 DOI: https://doi.org/10.4300/JGME-D-15-00391.1
Battistone MJ, Barker AM, Grotzke MP, Beck JP, Lawrence P, Cannon GW. “Mini-Residency” in musculoskeletal care: a national continuing professional development program for primary care providers. J Gen Intern Med. 2016;31(11):1301-1307. https://doi.org/10.1007/s11606-016-3773-4 DOI: https://doi.org/10.1007/s11606-016-3773-4
Jain SS, Nadler S, Eyles M, Kirshblum S, Delisa JA, Smith A. Development of an objective structured clinical examination (OSCE) for physical medicine and rehabilitation residents. Amer J Phys Med Rehab 1997;76(2):102-106. https://doi.org/10.1097/00002060-199703000-00003 DOI: https://doi.org/10.1097/00002060-199703000-00003
Irwin R, Smith J, Issenberg SB. Long-term retention of musculoskeletal ultrasound training during residency. Amer J Phys Med Rehab. 2018;97(7):523-530. https://doi.org/10.1097/PHM.0000000000000924 DOI: https://doi.org/10.1097/PHM.0000000000000924
Beran MC, Awan H, Rowley D, Samora J, Griesser MJ, Bishop JY. Assessment of musculoskeletal physical examination skills and attitudes of orthopaedic residents. J Bone Joint Surg - Series A. 2012;94(6):e36(1). https://doi.org/10.2106/JBJS.K.00518 DOI: https://doi.org/10.2106/JBJS.K.00518
McGaghie WC, Renner BR, Kowlowitz V, et al. Development and evaluation of musculoskeletal performance measures for an objective structured clinical examination. Teach Learn Med. 1994;6(1):59-63. https://doi.org/10.1080/10401339409539645 DOI: https://doi.org/10.1080/10401339409539645
Okoro T, Mironova P, Sathiyamoorthy T, et al. Correlation of residents’ performance in competency-based exams and orthopaedic in-training examinations (OITE). 2021; https://doi.org/10.21203/rs.3.rs-426917/v1 DOI: https://doi.org/10.21203/rs.3.rs-426917/v1
Oswald A, Bell M, Wiseman J, Snell L. The impact of trained patient educators on musculoskeletal clinical skills attainment in pre-clerkship medical students. BMC Med Educ. 2011;11(1)65. https://doi.org/10.1186/1472-6920-11-65 DOI: https://doi.org/10.1186/1472-6920-11-65
Raj N, Badcock L, Brown G, Deighton C, O'Reilly S. Undergraduate musculoskeletal examination teaching by trained patient educators - a comparison with doctor-led teaching. Rheumatol. 2006;45(11):1404-1408. https://doi.org/10.1093/rheumatology/kel126 DOI: https://doi.org/10.1093/rheumatology/kel126
Smith MD, Henry-Edwards S, Shanahan EM, Ahern MJ. Evaluation of patient partners in the teaching of the musculoskeletal examination. J Rheumatol. 2000;27(6):1533-1537.
Smith C, Newman B, Davis R, Yang J, Ramanan R. A comprehensive new curriculum to teach and assess resident knowledge and diagnostic evaluation of musculoskeletal complaints. Med Teach. 2005;27(6):553-558. https://doi.org/10.1080/01421590500156152 DOI: https://doi.org/10.1080/01421590500156152
Mehrpour SR, Aghamirsalim M, Motamedi SMK, Ardeshir Larijani F, Sorbi R. A supplemental video teaching tool enhances splinting skills basic research. Clinic Orth Related Res. 2013;471(2):649-654. https://doi.org/10.1007/s11999-012-2638-3 DOI: https://doi.org/10.1007/s11999-012-2638-3
Siddharthan T, Soares S, Wang HH, Holt SR. Objective structured clinical examination-based teaching of the musculoskeletal examination. Southern Med J. 2017;110(12):761-764. https://doi.org/10.14423/SMJ.0000000000000739 DOI: https://doi.org/10.14423/SMJ.0000000000000739
Smith M, Walker J, Schultz D, et al. Teaching clinical skills in musculoskeletal medicine: the use of structured clinical instruction modules. J Rheumatol. Apr 2002;29(4):813-7.
Yu JC, Guo Q, Hodgson CS. Deconstructing the joint examination: a novel approach to teaching introductory musculoskeletal physical examination skills for medical students. MedEdPORTAL. 2020;16:10945-10945. https://doi.org/10.15766/mep_2374-8265.10945 DOI: https://doi.org/10.15766/mep_2374-8265.10945
Chen ACY, Lee MS, Chen WJ, Lee ST. Assessment in orthopedic training - an analysis of rating consistency by using an objective structured examination video. J Surg Educ. 2013;70(2):189-192. https://doi.org/10.1016/j.jsurg.2012.11.002 DOI: https://doi.org/10.1016/j.jsurg.2012.11.002
Dwyer T, Wright S, Kulasegaram KM, et al. How to set the bar in competency-based medical education: standard setting after an Objective Structured Clinical Examination (OSCE). BMC Med Educ. 2016;16(1)506. https://doi.org/10.1186/s12909-015-0506-z DOI: https://doi.org/10.1186/s12909-015-0506-z
Macleod DA. Intercollegiate board for sport and exercise medicine. Brit J Sports Med. 2000;34(4):235-235. https://doi.org/10.1136/bjsm.34.4.235 DOI: https://doi.org/10.1136/bjsm.34.4.235
West LR, Griffin S. Sport and exercise medicine in the UK: what juniors should know to get ahead. 2017. Brit J Sports Med. https://doi.org/10.1136/bjsports-2016-096631. DOI: https://doi.org/10.1136/bjsports-2016-096631
Fricker P. Sports medicine education in Australia. Brit J Sports Med. 2000;34(4):240-241. https://doi.org/10.1136/bjsm.34.4.240 DOI: https://doi.org/10.1136/bjsm.34.4.240
Asif IM, Stovak M, Ray T, Weiss-Kelly A. Primary care sports medicine fellowship: AMSSM proposed standards of excellence. Clin J Sport Med. 2017;27(3):231-244. https://doi.org/10.1097/JSM.0000000000000428 DOI: https://doi.org/10.1097/JSM.0000000000000428
Hodges B, Regehr G, McNaughton N, Tiberius R, Hanson M. OSCE checklists do not capture increasing levels of expertise. Acad Med. 1999;74(10):1129-1134. https://doi.org/10.1097/00001888-199910000-00017 DOI: https://doi.org/10.1097/00001888-199910000-00017
Reid H, Gormley GJ, Dornan T, Johnston JL. Harnessing insights from an activity system–OSCEs past and present expanding future assessments. Med Teach. 2020:1-6. https://doi.org/10.1080/0142159X.2020.1795100 DOI: https://doi.org/10.1080/0142159X.2020.1795100
Lafave MR, Katz L. Validity and reliability of the standardized orthopedic assessment tool (SOAT): a variation of the traditional objective structured clinical examination. J Athlet Train. 2014;49(3):373-380. https://doi.org/10.4085/1062-6050-49.1.12 DOI: https://doi.org/10.4085/1062-6050-49.1.12
Patricio M, Juliao M, Fareleira F, Young M, Norman G, Vaz Carneiro A. A comprehensive checklist for reporting the use of OSCEs. Med Teach. 2009;31(2):112-24. https://doi.org/10.1080/01421590802578277 DOI: https://doi.org/10.1080/01421590802578277
Setyonugroho W, Kennedy KM, Kropmans TJB. Reliability and validity of OSCE checklists used to assess the communication skills of undergraduate medical students: a systematic review. J Pat Educ Counsel. 2015. https://doi.org/10.1016/j.pec.2015.06.004 DOI: https://doi.org/10.1016/j.pec.2015.06.004
Comert M, Zill JM, Christalle E, Dirmaier J, Harter M, Scholl I. Assessing communication skills of medical students in objective structured clinical examinations (osce)--a systematic review of rating scales. PloS one. 2016;11(3):e0152717. https://doi.org/10.1371/journal.pone.0152717 DOI: https://doi.org/10.1371/journal.pone.0152717
Khan R, Payne MWC, Chahine S. Peer assessment in the objective structured clinical examination: a scoping review. Med Teach. 2017;39(7):745-756. https://doi.org/10.1080/0142159X.2017.1309375 DOI: https://doi.org/10.1080/0142159X.2017.1309375
Martin RD, Naziruddin Z. Systematic review of student anxiety and performance during objective structured clinical examinations. Curr Pharm Teach Learn. 2020;12(12):1491-1497. https://doi.org/10.1016/j.cptl.2020.07.007 DOI: https://doi.org/10.1016/j.cptl.2020.07.007
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Reem El Sherif, Ian Shrier, Pierre-Paul Tellier, Charo Rodriguez
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Submission of an original manuscript to the Canadian Medical Education Journal will be taken to mean that it represents original work not previously published, that it is not being considered elsewhere for publication. If accepted for publication, it will be published online and it will not be published elsewhere in the same form, for commercial purposes, in any language, without the consent of the publisher.
Authors who publish in the Canadian Medical Education Journal agree to release their articles under the Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 Canada Licence. This licence allows anyone to copy and distribute the article for non-commercial purposes provided that appropriate attribution is given. For details of the rights an author grants users of their work, please see the licence summary and the full licence.
