Comparison of the objective structured clinical examination scores of students with and without a structured integrated clinical skills : laboratory curriculum

The Aga Khan University medical curriculum has changed from a traditional to a problem based learning curriculum. A recent internal review identified the need for an indepth exploration of the assessment process in undergraduate education. A major portion of assessment in clinical years is through on-going observations (continuous assessment) in clinical settings. Students have expressed dissatisfaction with their continuous assessment and faculty find assessment challenging due to time constraints. This has been an area of concern in year committee meetings. Therefore, this study was designed to understand issues related to \u27Student Continuous Assessment\u27. This study aimed to understand factors that influence faculty during student observation and assessment of performance at AKU — MC. Method: A case study with mixed quantitative and qualitative methods was undertaken at AKU. A questionnaire was developed and administered to medical faculty involved in undergraduate medical education. This questionnaire looked at faculty\u27s understanding of student assessment, professional and personal factors influencing assessment. Two focus group discussions were undertaken with key targeted questions derived from the quantitative data. A component of the Internal Review report was explored as part of qualitative analysis. For the quantitative aspect, descriptive and inferential analysis was performed using SPSS 19. Qualitative data was collated and a thematic analysis was performed after coding and data triangulation. Results: Time constraints during direct observation and assessment were identified in both qualitative and quantitative data sets. Overall understanding of assessment was satisfactory but superficial attributes were being used to assess students. Faculty rating styles and institutional culture both influenced student assessment. Key solutions identified were faculty training, sharing the validity and reliability of assessment with individual raters and more institutional support. Conclusion: Continuous assessment of medical students is a complex task that requires specific training, regular rater and student feedback and institutional support in order to be effective in achieving curricular goals