title: Standardized and quality-assured video-recorded examination in undergraduate education: informed consent prior to surgery.
abstract: BACKGROUND
  Communication skills combined with specialized knowledge are fundamental to the doctor-patient relationship in surgery. During a single-station video-recorded objective structured clinical examination (VOSCE), students were tasked with obtaining informed consent. Our aim was to develop a standardized and quality-assured assessment method in undergraduate education.
  
  
  METHODS
  One hundred fifty-five students in their fifth year of medical school (78 videos) participated in a summative VOSCE within the framework of the teaching module "Operative Medicine." They prepared for three clinical scenarios and the surgical procedures involved. The examination comprised participants having to obtain informed consent from simulated patients, video recording their performance. Students were assessed by two independent raters, the background of one of whom was nonsurgical. Results were statistically tested using SPSS.
  
  
  RESULTS
  Students' scores were all beyond the pass mark of 70%, averaging 91.0% (±4.0%), 88.4% (±4.4%), and 87.0% (±4.7%) for the appendectomy, cholecystectomy, and inguinal hernia repair checklist, respectively. Most items (68%-89% of the checklists) were found to have fair to excellent discrimination values. Cronbach's α values ranged between 0.565 and 0.605 for the individual checklists. Interrater agreement was strong (Pearson correlation coefficient = 0.80, P < 0.01; intraclass correlation coefficient 2.1 = 0.78).
  
  
  CONCLUSIONS
  The VOSCE is both feasible and reliable as a method of assessing student communication skills and the application of clinical knowledge while obtaining informed consent in surgery. This method is efficient (flexible rating outside normal working hours possible with reductions in administrative load) and may be used for high-stakes evaluation of student performance.
authors.affiliation: Department of General, Visceral and Paediatric Surgery, University Medical Centre Goettingen, Goettingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kiehl
authors.affiliation: Department of General Practice, University Medical Centre Goettingen, Goettingen, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Simmenroth-Nayda
authors.affiliation: Student Training Centre of Clinical Practice and Simulation, University Medical Centre Goettingen, Goettingen, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Goerlich
authors.affiliation: Department of Genetic Epidemiology, University Medical Centre Goettingen, Goettingen, Germany.
authors.forename: Andrew
authors.initials: A
authors.lastname: Entwistle
authors.affiliation: Office of the Dean of Studies, University Medical Centre Goettingen, Goettingen, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schiekirka
authors.affiliation: Department of General, Visceral and Paediatric Surgery, University Medical Centre Goettingen, Goettingen, Germany.
authors.forename: B Michael
authors.initials: BM
authors.lastname: Ghadimi
authors.affiliation: Department of Cardiology and Pneumonology, University Medical Centre Goettingen, Goettingen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Raupach
authors.affiliation: Department of General, Visceral and Paediatric Surgery, University Medical Centre Goettingen, Goettingen, Germany. Electronic address: skoenig1@gwdg.de.
authors.forename: Sarah
authors.initials: S
authors.lastname: Koenig
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000193:education; D057189:Checklist / Q000379:methods / Q000592:standards; D002763:Cholecystectomy / Q000193:education; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards*; D004521:Educational Measurement / Q000379:methods / Q000592:standards; D005260:Female; D013502:General Surgery / Q000193:education*; D005858:Germany; D059685:Herniorrhaphy / Q000193:education; D006801:Humans; D007258:Informed Consent / Q000592:standards*; D008297:Male; D010817:Physician-Patient Relations; D011300:Preoperative Care; D014741:Video Recording / Q000379:methods / Q000592:standards; D055815:Young Adult
keywords: Assessment; Communication skills; Informed consent; Interrater agreement; Medical education; OSCE; Quality assurance; Reliability of checklists; Simulated patients; Undergraduates