FHO.2

E-OSCE (phase 1)

Long Title: Electronic Registration of Objective Structured Clinical Examinations (phase 1)
Leading
Organization:
Fachhochschule Ostschweiz
Participating
Organizations:
Universität Bern
Other
Partners:
ETH Zürich
Crealogix (unfunded partner)
Domain: ELS
Status: finished
Start Date: 01.08.2009
End Date: 31.07.2010
Project Leader: M. Stolze
Website: http://www.e-osce.ch

E-OSCE allows examinators of clinical exams to use digital forms and to transmit results in real-time. Fill in paper forms will no longer be necessary. Instead TabletPCs, iPads etc. will facilitate the entry, transmission and analysis of examination data and break off the former media disruption.

(see also phase 2 and phase 3 )

Results

The deliverables (papers, manuals, documentation, reports, and software) are available upon request through the E-OSCE project website.
The project built on experience gained while developing a first prototype system called MoMEA. It investigated whether a highly mobile device (Apple iPhone) could be used to enter OSCE assessment data. The project yielded two main findings:

  1. a larger screen is needed and
  2. note taking ought to be supported.

Based on those results, it was decided that an implementation of the E-OSCE system should target tablet-sized computers. The software was tested on tablet PC's running Windows 7. Most tablets were

  • too bulky and too heavy to hold for an elongated period of time,
  • provide insufficient heat dispersion and
  • unsatisfactory touch and pen input,
  • are too expensive or
  • feature limited battery power.
Whilst very well received, also the tested iPad does have shortcomings. For instance, there is

  • limited support for text input (no stylus) and
  • missing connectivity options (USB-sticks) that might provide a challenge when dealing with data security.

Incremental releases of the E-OSCE system were developed and tested, using one or a combination of heuristic evaluations, simulated examinations and usability tests.
The system's release candiates, TabMed version 3.0 for Tablet PC and MoMEA for iPhone (RC, beta 2) as well as the modified iPad client (MoMEA), were put to the test by letting real examiners grade real students in the context of a real OSCE examination. All participants managed to complete their tasks without any serious problems. In fact, the examiners would prefer the E-OSCE System over the current paper based process.

Outlook

Given the still quickly changing hardware landscape, it was decided that an in depth investigation and platform comparison will be necessary to determine which platform is best suited for broad E-OSCE deployment at faculties across Switzerland. These issues will be addressed within the follow up project "E-OSCE Deployment & Dissemination" (phase 2).

Initial situation

Due to the reform of the curriculum (bachelor/master) and the introduction of a new federal exam starting in August 2011, OSCE assessments will dramatically gain in importance and frequency throughout the medical faculties in Switzerland (about 15'000/a).
OSCE stands for Objective Structured Clinical Examination. In this examination form, a medical student has to show his or her clinical skills (e.g. interviewing, clinical examination, etc.). The patients are specially trained actors that are instructed to verbally communicate the status and the symptoms of a certain illness. The performance of the students is evaluated by an expert.

Currently the process involves various media, is error prone and inefficient:
Evaluation sheets are prepared electronically, printed, manually filled out by the examiners on paper, and finally scanned to retrieve the evaluations from the sheet and store them electronically.

We intend to improve this process, digitise the workflow and allow further exams with mobile devices.

Goals

The goal of the proposed project is to develop a first productive release of a system supporting electronic registration of OSCE results. This is an efficient alternative to the current paper-based process. Here examiners use a electronic mobile device (such as an iPhone) which they can use for registering examination results on site. The result will be an optimized process that dramatically reduces the time until OSCE evaluations are available to Students.

  1. In December 2008 we started a self-funded first phase of the E-OSCE project. In this phase we develop the Alpha version of the mobile device software (device user interface, iPhone).
  2. The goal of this project (the second phase) is to produce the Release-1 version of the E-OSCE system (development of the necessary connectors for data import and export from and to the device).
    We expect that the Release-1 version will be further extended in follow-up projects while replicating the solution at different Swiss medical schools.
  3. To ensure the sustainable development a third developments phase will be needed for the integration of Release-1 into the existing infrastructure of the participating partners.

Benefits

  • E-OSCE will help to make the evaluation process of medical oral exams faster, more efficient and less error-prone.
  • Examinators may register examination results on site, what dramatically reduces the time until OSCE evaluations are available to students.

We will also organize two workshops. The first workshop in November 2009 will be to discuss and validate our technical architecture with other projects that work on related topics (e.g. SIOUX).
The second workshop in February 2010 will be held to present the status of the system to other Swiss medical schools (awareness, collect requirements, gain partners for a phase 2 project).

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