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Developing an objective structured clinical examination in comprehensive geriatric assessment - A pilot study

Lookup NU author(s): Emeritus Professor Stuart Parker

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).


Abstract

© 2019 Education for Health | Published by Wolters Kluwer - Medknow.Background: Acquiring medical competencies alone does not necessarily lead to the delivery of quality clinical care. Many UK training programs are soon to be based on the curricula of entrustable professional capabilities (EPCs). These are tasks carried out in practice requiring proficiency in several competencies for quality practice. Assessments to evaluate EPCs for independent practice are needed. Comprehensive geriatric assessment (CGA) is an EPC in geriatric medicine. We describe the development of an assessment of CGA as an example of examining EPCs. Methods: A CGA station was introduced in the Diploma in Geriatric Medicine clinical examination. Candidates rotate through four stations: three single competency-based stations (history, communication/ethics and physical examination) and an EPC-based station in CGA. Results: One hundred and seventy-eight (female: 96 [53.9%]) candidates took it. There was a weak but significantly positive correlation between the score at CGA and the total score in the other stations (r = 0.46; P < 0.001). Most candidates passing the station passed the examination. Correlation with other stations similarly showed weak significant correlations (Station 1: r = 0.38; P < 0.001, Station 3: r = 0.28; P < 0.001, and Station 4: r = 0.37; P < 0.001). There was 61.4% (kappa: 0.61; P = 0.000) agreement between examiners whether a candidate passed or failed. Agreement was higher for the other stations, i.e. Station 1 (kappa: 0.85; P < 0.001), Station 3 (kappa: 0.72; P < 0.001), and Station 4 (kappa: 0.85; P < 0.001). Discussion: Performance on the station correlated positively with overall performance, suggesting that it has discriminatory value in differentiating candidates with varying ability and the more able candidates pass the examination.


Publication metadata

Author(s): Vassallo M, Grey J, Hemsley A, Chris L, Parker S

Publication type: Article

Publication status: Published

Journal: Education for Health: Change in Learning and Practice

Year: 2019

Volume: 32

Issue: 2

Pages: 95-98

Print publication date: 01/05/2019

Online publication date: 18/11/2019

Acceptance date: 02/04/2019

Date deposited: 02/12/2019

ISSN (print): 1357-6283

ISSN (electronic): 1469-5804

Publisher: Wolters Kluwer Medknow Publications

URL: https://doi.org/10.4103/efh.EfH_111_18

DOI: 10.4103/efh.EfH_111_18

PubMed id: 31745004


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