Que savons-nous de l'examen clinique objectif structuré en médecine du sport et de l'exercice ? Une revue de l'étendue des connaissances
DOI :
https://doi.org/10.36834/cmej.77841Résumé
Contexte et objectifs : Malgré l'importance de l'examen clinique objectif structuré (ECOS) en médecine du sport et de l'exercice, la littérature sur le sujet est fragmentée et peu développée. L'objectif de cette étude était de cartographier les connaissances actuelles sur l'utilisation de l'ECOS en médecine du sport et de l'exercice, et d'identifier les lacunes en matière de connaissances en vue de recherches futures.
Méthode : Les auteurs ont procédé à un examen approfondi. Ils ont recherché dans PubMed et Scopus des articles utilisant des termes clés liés à "OSCE" et "médecine du sport" sans limite de date de début de recherche et jusqu'en juillet 2022. Les enregistrements trouvés ont été importés, les résumés ont été examinés et les articles en texte intégral ont été examinés. Un suivi des citations en avant et en arrière a été effectué. Les données ont été extraites et un méta-résumé qualitatif des études a été réalisé.
Résultats : Au total, 469 dossiers ont été examinés et 22 études ont été incluses. Les objectifs des études comprenaient l'utilisation des ECOS pour évaluer les connaissances/compétences après un programme de formation (n = 11), pour évaluer une intervention (n = 8), et pour évaluer et améliorer l'ECOS lui-même (n = 3). Treize études ont fait état de la validité et/ou de la fiabilité des ECOS.
Conclusion : Malgré l'utilisation répandue des ECOS dans l'examen des stagiaires en médecine du sport et de l'exercice, seuls quelques travaux scientifiques ont été publiés. Des recherches supplémentaires sont nécessaires pour soutenir l'utilisation de l'OSCE en médecine du sport et de l'exercice pour son objectif initial. Nous mettons en évidence des pistes de recherche futures telles que l'évaluation de la nécessité d'une exploration plus approfondie de la relation entre les caractéristiques des candidats et les résultats des ECOS.
Statistiques
Références
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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.
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
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
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
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
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
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
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
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
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
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
Téléchargements
Publié-e
Comment citer
Numéro
Rubrique
Licence
(c) Tous droits réservés Reem El Sherif, Ian Shrier, Pierre-Paul Tellier, Charo Rodriguez 2023
Cette œuvre est sous licence Creative Commons Attribution - Pas d'Utilisation Commerciale - Pas de Modification 4.0 International.
La soumission d’un manuscrit original à la revue constitue une indication qu’il s’agit d’un travail original, qu’il n’a jamais été publié et qu’il n’est pas envisagé pour publication dans une autre revue. S’il est accepté, il sera publié en ligne et ne pourra l’être ailleurs sous la même forme, à des fins commerciales, dans quelque langue que ce soit, sans l’accord de l’éditeur.
La publication d’une recherche scientifique a pour but la diffusion de connaissances et, sous un régime sans but lucratif, ne profite financièrement ni à l’éditeur ni à l’auteur.
Les auteurs qui publient dans la Revue canadienne d’éducation médicale acceptent de publier leurs articles sous la licence Creative Commons Paternité - Pas d’utilisation commerciale, Pas de modification 4.0 Canada. Cette licence permet à quiconque de télécharger et de partager l’article à des fins non commerciales, à condition d’en attribuer le crédit aux auteurs. Pour plus de détails sur les droits que les auteurs accordent aux utilisateurs de leur travail, veuillez consulter le résumé de la licence et la licence complète.
