An implementation strategy for introducing an OSCE into a dental school.
BACKGROUND
The Objective Structured Clinical Examination (OSCE) uses a series of test-stations to test clinical competencies. The introduction of an OSCE in a dental school is always a new experience for both staff and students and may result in a change in assessment methods. As resistance could develop when changes are introduced into an organisation, the use of a strategy for the implementation of such change will help to diminish opposition and may therefore result in the co-operation of staff and their departments. The objective of this study was to investigate the effectiveness of an implementation strategy by measuring attitudes of both staff and students towards the OSCE as a new form of clinical assessment in a dental school (ACTA).


METHODS
'Stepwise' behaviour change (with information, participation and commitment as tools) was used as a strategy to minimise protective behaviour to the introduction of an OSCE. After lectures on assessment, 59 staff members participated in a mini-OSCE with eight test-stations, playing both the role of a student and observer. A questionnaire, designed to test attitudes and commitment towards the new OSCE was completed after the examination. Six months later, 22 staff of all departments had developed and run a pilot OSCE for 44 students. A similar questionnaire was answered by staff and students. A year later, another OSCE for all 103 third year students was designed, organised and evaluated with full co-operation of the clinical teaching staff.


RESULTS
Staff total attitude grew positively (P = 0.001). Student's total attitude was lower than staff (P < 0.001) The results of the survey after the mini-staff-OSCE and pilot and final OSCE were favourable in terms of the acceptance of use of an OSCE for the assessment of clinical competences.


CONCLUSIONS
The implementation strategy appears to have been successful. The objective of gaining the co-operation of staff and departments and avoiding resistance to change was achieved.
Schoonheim-Klein
M
M
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. m.schoonheim@acta.nl
Walmsley
A D
AD
Habets
L
L
van der Velden
U
U
Manogue
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M
D001290:Attitude; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004497:Education, Dental; D004521:Educational Measurement / Q000379:methods; D005179:Faculty, Dental; D006801:Humans; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D012575:Schools, Dental; D013335:Students, Dental; D011795:Surveys and Questionnaires