Publicado

2022-04-01

Implementation of an Objective structured clinical examination (OSCE) as a tool to evaluate the development of clinical reasoning in physical therapy students

Implementación de un Examen clínico objetivo estructurado (ECOE) como herramienta para evaluar el desarrollo del razonamiento clínico en estudiantes de fisioterapia

Palabras clave:

Educational Measurement, Clinical Competence, Physical Therapists, Professional Competence (en)
Evaluación Educacional, Habilidades clínicas, Fisioterapia, Competencia profesional (es)

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Autores/as

  • Nicole Figueroa-Arce Universidad Andrés Bello - Facultad de Ciencias de la Rehabilitación - Escuela de Terapia Física - Instituto de Ejercicio y Rehabilitación - Santiago de Chile - Chile. https://orcid.org/0000-0001-8486-3652
  • Paola Figueroa-González Universidad Andrés Bello - Facultad de Ciencias de la Rehabilitación - Escuela de Terapia Física - Instituto de Ejercicio y Rehabilitación - Santiago de Chile - Chile. https://orcid.org/0000-0003-0272-5331
  • Luis Gómez-Miranda Universidad Andrés Bello - Facultad de Ciencias de la Rehabilitación - Escuela de Terapia Física - Instituto de Ejercicio y Rehabilitación - Santiago de Chile - Chile. https://orcid.org/0000-0003-3593-4244
  • Ruvistay Gútierrez-Arias Universidad Andrés Bello - Facultad de Ciencias de la Rehabilitación - Escuela de Terapia Física - Instituto de Ciencias del Ejercicio y la Rehabilitación -Santiago de Chile - Chile. | Instituto Nacional del Tórax - Servicio de Medicina Física y Rehabilitación - Santiago de Chile - Chile. https://orcid.org/0000-0003-1881-9316
  • Viviana Contreras-Pizarro Universidad Andrés Bello - Facultad de Ciencias de la Rehabilitación - Escuela de Terapia Física - Instituto de Ciencias del Ejercicio y la Rehabilitación -Santiago de Chile - Chile. https://orcid.org/0000-0002-9366-2817

Introduction: Clinical reasoning involves critical thinking and decision-making in clinical situations. It can be evaluated using Objective structured clinical examination (OSCE), which measures clinical skills associated with the development of clinical reasoning.

Objective: To describe the implementation of an OSCE to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and to determine their level of satisfaction with this methodology.

Materials and methods: Cross-sectional descriptive study conducted in 159 physical therapy students from Universidad Andres Bello, Chile, enrolled in the Reasoning in Physical therapy course (second semester of 2018). The OSCE had 11 stations and a student satisfaction survey was administered. Data normality was determined using the Shapiro-Wilk test. Descriptive statistics (percentages, medians, and interquartile ranges (IQR)) were used for data analysis.

Results: The median global score was 142 points (IQR: 132-150) and 61.1% of the students obtained a passing score (≥ 134 points). Stations in which most students had a passing score were S3, S5 and S7 (standardized patient stations): 78.62%, 96.85% and 85.53%, respectively. Regarding the satisfaction survey, 36.48% and 59.12% of the students agreed and strongly agreed with using tools that assess their clinical skills.

Conclusions: The OSCE was successfully designed and implemented to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and most of them reported a high level of satisfaction with its use; this confirms OSCE is an excellent methodology to train and evaluate these students.

Introducción. El razonamiento clínico implica el pensamiento crítico y la toma de decisiones en situaciones clínicas. Esto puede evaluarse mediante el Examen clínico objetivo estructurado (ECOE), que mide las habilidades clínicas asociadas con el desarrollo del razonamiento clínico.

Objetivo. Describir la implementación de un ECOE para evaluar las habilidades clínicas asociadas con el desarrollo de razonamiento clínico en estudiantes de fisioterapia, así como su nivel de satisfacción con esta metodología.

Materiales y métodos. Estudio transversal descriptivo realizado en 159 estudiantes de fisioterapia de la Universidad Andres Bello, Chile, inscritos en el curso Razonamiento en Fisioterapia (segundo semestre de 2018). El ECOE contó con 11 estaciones y se aplicó una encuesta de satisfacción estudiantil. La normalidad de los datos se determinó mediante la prueba de Shapiro-Wilk y el análisis de los datos se realizó mediante estadística descriptiva (porcentajes, medianas y rangos intercuartílicos (RIC)).

Resultados. La mediana del puntaje global fue de 142 puntos (RIC: 132-150) y el 61.1% de los estudiantes obtuvo una puntuación aprobatoria (≥ 134 puntos). Las estaciones con mayor número de estudiantes con un puntaje aprobatorio fueron E3, E5 y E7 (estaciones con paciente estandarizado): 78.62%, 96.85% y 85.53%, respectivamente. Respecto a la encuesta de satisfacción, 36.48% y 59.12% de los estudiantes estuvieron de acuerdo y muy de acuerdo con el uso de herramientas que evalúen sus habilidades clínicas.

Conclusiones. El ECOE fue diseñado e implementado exitosamente para evaluar las habilidades clínicas asociadas con el desarrollo del razonamiento clínico en estudiantes de fisioterapia; además, la mayoría de ellos reportó altos niveles de satisfacción con su uso, lo que confirma que es una excelente metodología para capacitar y evaluar estos estudiantes.

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