|Year : 2016 | Volume
| Issue : 1 | Page : 1-2
Clinical Skills Testing Centre: A promising frontier
Department of Medical Education, The Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia
|Date of Web Publication||13-Jan-2016|
Dr. Fadi Munshi
Department of Medical Education, The Saudi Commission for Health Specialties, P.O. Box: 94656, Riyadh 11614
|How to cite this article:|
Munshi F. Clinical Skills Testing Centre: A promising frontier. J Health Spec 2016;4:1-2
Clinical examinations aim to ensure that a candidate has the necessary clinical competencies relevant to his/her speciality. As a performance-based tool, Objective Structured Clinical Examinations (OSCEs) have advantages over other forms of assessment, such as oral examinations. Ethical judgement, communication and interpersonal skills, professional behaviour and complex ethical problem identification as well as resolution skills may be assessed more effectively and efficiently through a well-designed OSCE, rather than through other testing methods. OSCEs have not been used extensively, in part due to the high costs and difficulties associated with developing and administering this form of assessment.
There was a realisation that traditional examination formats may not adequately measure some important clinical competencies. Recognising that well-designed OSCEs had established reliability and validity in health professions, the Saudi Commission for Health Specialties (SCFHS) in its 2015 revised the examination rules and regulations, specifying that the format for the final clinical examinations would consist of a combination of structured oral exams and OSCE stations.
Due to the high stakes nature of this work, a detailed development process was outlined, which included: (1) Developing a blueprint for the clinical examination, (2) conducting station development workshops, (3) conducting station review sessions, (4) developing performance evaluation instruments, (5) undertaking standard-setting workshops and (6) recruiting and training standardised patients (SPs).
In addition to the effort put into test design, SCFHS was keen to establish a suitable venue for clinical examinations, the Clinical Skills Testing Center (CSTC), which was officially opened on November 30, 2015.
CSTC is a state-of-the-art facility located within the SCFHS. It is a specialised resource designed, built and operated for the express purpose of administrating clinical exams. The centre encompasses:
- Simulated clinical practice environment with 14 fully-equipped examination rooms
- Computer-based collections of post-encounter exercises
- Centralised control room with audio-visual monitoring and recording capabilities
- Specially trained staff of SPs, proctors and control room operators
- Protocols designed to ensure the security of examination materials.
General Surgery Examination Committee was the first committee to go through this extensive development process and utilize the CSTC to its full potential in December 2015 for the Saudi Board final clinical examination. Examiners and candidates were highly impressed with the facilities and overall examination organisation.
Given the new examination format, pre-exam orientation was conducted for candidates in two major cities, Riyadh and Jeddah. One day prior to the examination, all examiners were given hands-on practice using the electronic monitoring and scoring system. More time was needed for hands-on training, therefore, a strategic decision was made to rely primarily on printed performance evaluations with the option of entering the scores electronically. As the 3-day examination progressed, examiners were feeling more comfortable and confident utilising the electronic scoring system. CSTC organisers gave attention to fine details to ensure that candidates had a joyful experience on a stressful examination day.
The biggest advantage obtained from the CSTC electronic system was the ability to audit scores obtained in randomly selected clinical encounters. Independent examiners were assigned to review 2–3 videotaped clinical encounters and evaluate them. Scores from the original and reviewed performance evaluations were compared as a quality assurance measure. This was of highest value for borderline pass/fail candidates.
I extend a special thanks to the members of the Saudi Board General Surgery Examination Committee for their time and efforts in planning and conducting such a clinical examination. It was a positive experience for examiners and candidates, which can be summarised in one of the surgical resident's statements, 'This was the first clinical exam I truly enjoyed!'