reshma ansari

Objective Structured Clinical Examination (OSCE) is a crucial component in medical school examinations to assess students’ competency, particularly in clinical skills incorporating cognitive and affective domains. OSCE results are subjected to standard-setting methods, which yield different findings. Hence, in this study, five different standard-setting methods, namely norm reference, Angoff method, borderline group method (BGM), borderline regression method (BRM), and modified Cohen’s method, were compared to determine the cut-off scores and failure rates determined by each method.

Data of 170 second-year medical students who attended OSCE with eight stations for their First Professional Examination at the end of year 2 MBBS was taken for the study following ethical approval. Total scores for each station were standardized to 20 marks, and cut-off scores were determined using each of the five standard-setting methods.

As a comparison of 5 methods, the Norm reference method yielded the highest number of stations with high cut-off scores, followed by BRM. This is reflected in the number of failures, too. On the contrary, using the Angoff method yielded the lowest cut-off scores in maximum stations, resulting in the least number of failed students. The Cochrane’s Q test of the results yielded a p < 0.001, which signifies that the proportion of students who failed a particular OSCE station was significantly different when different methods were used to determine the cut score.

The study, which compared 5 common standard-setting methods employed in medical education assessments, found that norm-referenced and BRM had high cut-off scores and failures, with the opposite determined by the Modified Angoff method. The study concluded that the cut-off score and failure rate differed with different standard-setting methods, and the choice of the method is contextual depending on the available resources.

With student-centered teaching-learning making the forefront in medical education, this qualitative study was set out to investigate the perceptions of students on the factors that enable or impede the outcome achievement of problem-based method of teaching-learning.

Ten students embarking their year 2 Bachelor of Medicine, Bachelor of Surgery (MBBS) study in a private university in Malaysia agreed to participate in this study. The students were subjected to semi-structured, in-depth, one-to-one interviews following their consent. The interview protocol was prepared following guidelines, objectives of the study and from the available literature. The data thus collected was subjected to thematic analysis using NVivo.

Analysis revealed emergence of codes such as student characteristics and perception, facilitators, team factors, content and conduct of problem-based learning. These codes were then collapsed into themes. The major themes or factors that enabled or impeded the outcomes of PBL were student factors, facilitator factors and factors related to the learning environment.

The study concluded that among the various factors that enable or impede PBL teaching-learning method, there are pros and cons among the student, facilitators and learning environment that may facilitate or impede the realisation of PBL outcomes. This study would shed light into the students’ perception of PBL and enable facilitators to ensure that PBLs are student-friendly.