111 - The Objective Structured Clinical Examination – Anatomy (OSCE-A): A New Performance-based Lab Practical for Medical Education

Poster Board Number: 111
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Co-authors:

Chelsea Lohman - University of Colorado School of Medicine; Briauna Johnson - University of Colorado School of Medicine; Zach Throckmorton - University of Colorado School of Medicine - Fort Collins Branch; Rachael Tan - University of Colorado School of Medicine

Abstract Body : Introduction




As medical education evolves so must anatomy assessments. A novel performance-based lab exam was created, modeled on the Objective Structured Clinical Examination (OSCE), to better measure students’ ability to apply anatomy. This study describes the OSCE-Anatomy (OSCE-A) and evaluates its efficacy in a longitudinally integrated 1st year medical curriculum.






Methods
The OSCE-A measures gross anatomy knowledge and skill using the cadaver as a patient. Students answer clinical vignettes by tagging relevant structures on a cadaver, integrating imaging, physical exam findings, or anatomy concepts. By manipulating the cadaver, using anatomic relations, and navigating variation or pathology, the OSCE-A simulates how anatomy is applied in a patient encounter to assess higher levels in Bloom’s Taxonomy and Miller’s Pyramid of Clinical Competence.




Three OSCE-A practicals were used in AY21-22 and AY22-23 (N=368) cohorts in an integrated, longitudinal 1st year medical curriculum. Content validity from blueprinting was further supported by item quality evidence obtained during psychometric review. Reliability was determined by KR-20 and extrapolated using the Spearman-Brown formula. Quantitative curricular data (exam scores, evaluation ratings) were summarized with descriptive statistics, and year-end evaluation comments were analyzed for emerging themes (IRB-exempted).






Results
Across exams, the items discriminated well (average 0.31), and KR-20 coefficients showed excellent reliability for 20 items (range 0.43-0.54). The Spearman-Brown formula predicted OSCE-A reliability ~0.80 when scaled to 80 items, on par with high-stakes exams. OSCE-A failure rates were low in both cohorts across all exams: 8-11% in AY21-22, and 5-12% in AY 22-23 and average scores were appropriate (79-83%, 80-86% respectively). Students mostly agreed the OSCE-A was well aligned with the curriculum (61% and 68%) and was fair (58% and 65%). Most students agreed the OSCE-A assessed clinically relevant knowledge (89% and 92%), while the AY22-23 cohort had stronger belief that the OSCE-A was authentic in assessing anatomy (68% vs 80%). Thematic analyses show desire for longer exam time, exam question modification, cadaver challenges, and benefit to future practice.






Conclusion & Significance




Data support the OSCE-A’s validity, reliability, and psychometric performance in pre-clinical medical education. Students perceive it as fair and clinically relevant while highlighting areas for continued improvement. The OSCE-A is a more suitable assessment for pre-clinical medical education than traditional ‘bellringer’ practicals. Future studies will compare the OSCE-A to traditional lab exams and examine the impact of exam format on student confidence and clinical performance.