Clinical competencies of students in urgent and emergency care: evolutive analysis through OSCE

Abstract: Introduction: One of the major challenges in evaluating medical education is measuring practical skills, crossing the limits of theoretical knowledge. The Objective Structured Clinical Examination (OSCE) is an alternative for active and standardized assessment of clinical competencies. Despite its growing implementation, longitudinal studies that support its evaluative potential are still scarce. Objective: To analyze the learning curve of medical students based on continuous assessment of their OSCE exams and individual performances within the discipline of Urgent and Emergency Care. Method: This retrospective study is based on the analysis of data taken from assessment checklists from three consecutive OSCEs applied to sixth-year Brazilian medical students within the Urgent and Emergency Care program of the 2019 academic year. Result: 270 assessment sheets from a total of 90 students were analyzed. The group was made up of 51 females (56.7 percentage points) and 69 of the students (or 76.7 percentage points) were aged between 23 and 26 years old. Between the first and third OSCE, 67 students (74.4 percentage points) increased their final grade, the median of which increased by an average of 1.5 points. Of the four medical components evaluated - conduct, recognition, interaction and follow-up - there was an improvement of 15.5 percentage points in correct conduct, zero impact on the results concerning recognition and drops of 19.4 and 16.1 percentage points in the areas of communication and follow-up, respectively. Conclusion: The study points to an increasing curve in OSCE scores, suggesting an increase in general learning in Urgent and Emergency Care over the course of the year. However, careful analysis of the components reveals different performance curves. Since it is not possible to presume the causes of these counterpoints, further studies in the area are suggested.