(1106) Novel Hybrid model of OSCE with Mini CEX for Formative assessment in Competency-based medical Education

Introduction: Formative assessment of “must to know” competencies has become increasingly challenging with the rising enrolment in undergraduate medical education, with limited available faculty time. To address this, we evaluated the effectiveness of a novel hybrid model that integrates the principles of OSCE and Mini-CEX

Methods: This model used 7 evaluation(Q) stations of 5 min duration each with an aim to evaluate “shows how” and “does” domains of clinical skills. The performance was scored as per mini-CEX criteria: scale of 0-9 (1-3: unsatisfactory, 4-6: satisfactory, 7-9: superior). Undergraduates (N=244) were evaluated after a proper orientation. The evaluation domains were Medical interviewing skills (MIS) (Q1: history taking), Physical examination skills (PES) (Q2: otoscopy, Q3: tuning fork testing), Professionalism/ communication skills (PCS) (Q6: counselling/ communication ability), and Clinical reasoning/ Judgement (CRJ) (Q4: diagnosis, Q5: management paradigm, Q7: overall knowledge). Four were patient-stations (resident observers), and 2 (Q4/Q5) were for judging comprehensive writing skills. Only last station required assessment by faculty. Feedback was provided at all the stations except Q4/Q5. Similar evaluation was undertaken at the end of clinical posting

Results: This method was very time effective (30 students in 2.5hrs). The domains scores in initial assessment were: MIS 4.79 (SD 1.46, range 1-8), PES 4.55 (SD 1.99, range 1-7.5), PCS 2.98 (SD 1.03, range 1-7), and CRJ 3.43 (SD 1.99, range 1-5.6). The repeat assessment (N 181) revealed enhanced scores: MIS 6.86 (SD 1.47, range 3-9), PES 6.06 (SD 1.22, range 3-8.5), PCS 5.01 (SD 1.02, range 3-7), and CRJ 4.43 (SD 1.22, range 2-7). A statistically significant improvement (p < 0.05) in all domains was evident. Overall consolidated average score (in maximum 63) significantly improved from 27.18 (SD 7.02, range 8-42), to 37.29 (SD 7.15, range 18-51)

Conclusions: This hybrid approach offers time efficient and effective strategy for evaluating practical skills within CBME, while also capturing overall clinical performance and progress