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Objective structured clinical examination (OSCE) to assess the clinical skills of physical therapy students when using physical agents
Evaluación clínica objetiva estructurada (ECOE) para evaluar las habilidades clínicas de los estudiantes de fisioterapia al utilizar agentes físicos
Palabras clave:
Physical Therapy Modalities, Physical and Rehabilitation Medicine, Learning, Student Health Services (en)Fisioterapia, Modalidades de Fisioterapia, Estudiantes, Educación (es)
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Introduction: The use of physical agents in physical therapy (PT) requires clinical reasoning, as well as knowledge of their risks and contraindications; however, deficiencies may be observed when used in clinical practice.
Objective: To implement the Objective Structured Clinical Evaluation (OSCE) method for the assessment of clinical skills among physical therapy specialty students when using physical agents.
Materials and methods: A pilot, non-experimental, cross-sectional study was conducted in 114 physical therapy students enrolled during the first semester of 2019 in a physical agents course offered at the Universidad Andres Bello, Santiago, Chile. The OSCE consisted of 7 peer-validated stations, in which various skills were implemented in simulated clinical scenarios to achieve learning outcomes associated with the use of physical agents, namely: S1: connective tissue flexibility; S2: muscle relaxation; S3: analgesia; S4: drainage; S5: muscle strengthening; S6: parameter interpretation; and S7: equipment installation. Observers at each station assessed students’ clinical skills and decision-making using a checklist. OSCE scores were described using medians and interquartile ranges, representing the data dispersion between the 25th and 75th percentile (P25-P75). Station scores by sex were compared using the Mann-Whitney U test.
Results: Median scores were higher than the minimum passing score in stations S1 (66, IQR: 52-70), S2 (55, IQR: 45-60), S3 (60, IQR: 50-69), S4 (65, IQR: 55-73), and S7 (40, IQR: 33-45), but they were below the passing score in stations S5 (54, IQR:46-65) and S6 (10, IQR: 9-13). In addition, 101 (88.59%) students had a global passing score in the OSCE.
Conclusion: The OSCE scores obtained by the participants show their attainment of clinical skills when using physical agents since most of them obtained a global passing score; however, reinforcing the clinical skills for parameter interpretation is necessary, considering that the lowest mean score was obtained in said station.
Introducción. El uso de agentes físicos en el ejercicio de la fisioterapia requiere razonamiento clínico y saber sus riesgos y contraindicaciones, aunque en ocasiones se observan deficiencias al utilizarlos en la práctica clínica.
Objetivo. Implementar la metodología de Evaluación Clínica Objetiva Estructurada (ECOE) para la evaluación de habilidades clínicas en estudiantes de fisioterapia al aplicar agentes físicos.
Materiales y métodos. Se realizó un estudio piloto transversal no experimental en 114 estudiantes de fisioterapia inscritos en el primer semestre de 2019 en la asignatura de agentes físicos en la Universidad Andrés Bello, Santiago de Chile, Chile. La ECOE consistió de siete estaciones validadas por pares en las que se implementaron diversas habilidades en escenarios clínicos simulados para lograr resultados de aprendizaje asociados al uso de agentes físicos, a saber: E1: Flexibilidad tejido conectivo, E2: Relajación muscular, E3: Analgesia, E4: Drenaje, E5: Fortalecimiento, E6: Interpretación de parámetros y E7: Instalación de equipo. En cada estación, las habilidades clínicas y toma de decisiones fueron evaluadas por observadores usando listas de verificación. Las puntuaciones en la ECOE se describieron usando medianas y rangos intercuartiles, representado la dispersión de los datos entre el percentil 25 y 75 (P25-P75). Los puntajes en cada estación fueron comparados por género mediante la prueba de U de Mann-Whitney.
Resultados. Las medianas de puntaje fueron superiores al puntaje aprobatorio en las estaciones E1 (66, RIC: 52-70), E2 (55, RIC: 45-60), E3 (60, RIC: 50-69), E4 (65, RIC: 55-73) y E7(40, RIC: 33-45), pero inferiores en las estaciones E5 (54, RIC: 46-65) y E6 (10, RIC: 9-13). Además, 101 estudiantes (88.59%) obtuvieron un puntaje aprobatorio global en la ECOE.
Conclusión. Los puntajes obtenidos en la ECOE por los participantes demuestran el logro de habilidades clínicas al utilizar agentes físicos, pues la mayoría obtuvo una nota aprobatoria global. No obstante, se requiere reforzar las habilidades clínicas de interpretación de parámetros, estación en la que se obtuvo la media de puntaje más baja.
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