title: [Objective structured clinical examination (OSCE) on completion of surgical block practical training--twelve months experience with a hands-on examination].
abstract: BACKGROUND
  According to the approval system for medical doctors, practical courses such as block practical training must be graded. The grading of the surgical block practical training at the Klinikum rechts der Isar, Technische Universität of Munich (TUM), was changed from single grades of each day to a final objective structured clinical examination (OSCE). We report about the experiences in the past 12 months with this relatively new form of examination.
  
  
  METHODS
  An OSCE was established as a practical exam with seven stations about suture techniques, internal fixation, first-aid education, hygiene and sterility, clinical examination and perioperative management. The feasibility of a comprehensive OSCE with the necessary modifications was studied and the grades had been compared.
  
  
  RESULTS
  In the past 12 months four surgical block placements for over three weeks had been organised with a total of 326 students. 309 students were admitted for the OSCE at the end of block practical training. The average score was 1.75. The medical student raters graded either equally or more stringently compared to the medical doctors. The transcript revealed in all OSCEs a normal distribution of grading with high validity. However, an adaptation of the evaluation forms and an extension of the stations with modified content was required to obtain the same test conditions for all students. The implementation of the OSCE on this scale is possible with adequate preparation time and sufficient financial support. The evaluation of the specimens after completion of the test were all positive.
  
  
  CONCLUSIONS
  The new medical approval system calls for restructuring, not only in teaching but also in the form of examination of the courses. Through this practical test, those skills of a student will be assessed that cannot be tested by the IMPP exam. Moreover, this examination form provides an excellent preparation for the practical part of the oral state examination. This OSCE is even feasible with high numbers of students and offers with appropriate adaptation of the evaluation forms and test stations, a normal distribution of grading.
authors.affiliation: Klinikum rechts der Isar, Technische Universität München, Chirurgische Klinik und Poliklinik, München, Germany. brauer@chir.med.tu-muenchen.de
authors.forename: R B
authors.initials: RB
authors.lastname: Brauer
authors.forename: A
authors.initials: A
authors.lastname: Kammerloher
authors.forename: K
authors.initials: K
authors.lastname: Stering
authors.forename: G
authors.initials: G
authors.lastname: Womes
authors.forename: J
authors.initials: J
authors.lastname: Ring
authors.forename: H
authors.initials: H
authors.lastname: Friess
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003479:Curriculum / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000592:standards*; D005240:Feasibility Studies; D013502:General Surgery / Q000193:education*; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D013044:Specialty Boards / Q000592:standards*