An Application of an Objective Structured Clinical Examination for Learning Skills in Assessment of Physical Therapy : A Task Involving Measurements on the Range of Motion Test

OSCEは,臨床実習に出る前の医学生の臨床能力を客観的に評価できる優れた試験である。また,OSCEは臨床技能習得の有用な手法になり得ると考えられる。そこで,我々は臨床実習前の理学療法学科学生に独自のOSCEを試行して,有用性を検討した。独自のOSCEでは,理学療法学科3年生10名が,課題として股関節のROM-Tを測定し, PT教員2名とSP1名に評価された。学生は基礎的な知識をほぼ理解していたが,角度計の操作,下肢の保持等の技術面で不十分さが認められた。ROM-T実施に関する学生の自己評価とSP・PT教員の評価は類似しており,学生はROM-T測定の応用能力が不十分であった。OSCEは臨床に近い状態を設定でき,臨床実習前の学生にとって技術習得に非常に有用である。特に録画を見ながら実施した評価者から学生へのフィードバックが有効であった。OSCEは学生の学習の動機付けともなり,教員の教育方法・内容の改善にも結びつく貴重な機会であった。OSCEの今後の課題は,時間・労力の多大さ,SPの確保・教育等である。The Objective Structured Clinical Examination (OSCE) is very useful for evaluating the clinical abilities of medical students before general clinical training. OSCE can also be a useful means for learning clinical skills. We devised and practiced an original OSCE for physical therapy students (PTSs) before general clinical training, and examined the usefulness of our original OSCE. In our original OSCE, ten third year PTSs measured for a task on the hip joints of a standardized patient (SP) in a range of motion test (ROM-T) and were evaluated by two examiners and the SP. PTSs mostly had basic knowledge of ROM-T, but they did not have enough skills in handling a goniometer and the lower limbs of a SP and so on; PTSs\u27 self-evaluations of the performance of ROM-T were similar to the examiners\u27 and SP\u27 s evaluations; PTSs did not have enough applied abilities of measurements of ROM-T.We can set up similar situations to clinical scenes, so we think OSCE can be very useful to learn clinical skills for PTSs before general clinical training. In our OSCE, feedback from examiners and SP to PTSs while watching recorded video tapes was especially useful our original. OSCE can give a motivation of study for students and a valuable chance for improvements of education methods and contents for teachers. Problems with our OSCE are that we need a lot of time and manpower and it is difficult to train and keep SPs