한국 의사면허시험에서의 OSCE(Kaohsiung J Med Sci. 2008)

한국 의사면허시험에서의 OSCE(Kaohsiung J Med Sci. 2008)

OSCE FOR THE MEDICAL LICENSING EXAMINATION IN KOREA (Kaohsiung J Med Sci. 2008)

Yoon-seong Lee

Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea.

BACKGROUND

한국의 NHPLEB는 미국의 NBME와 유사하며 MLE의 Skills and Attitude Test를 담당하고 있다. 대만과 같이 KMLE는 60년이 넘었으며 1년에 1회 시행된다.

The National Health Personnel Licensing Exami- nation Board (NHPLEB), which is akin to the National Board of Medical Examiners (NBME) in the USA, is responsible for the Skills and Attitude Test of the Medical Licensing Examination. As in Taiwan, the Korean Medical Licensing Exam has been a written exam for more than 60 years, and is usually given once a year.

2006년 한국의 MOHW 실기시험 도입을 선언하였다. 의사면허시험에서 최초의 실기시험은 2009년 후반에 시행되었으며, 정부의 선언은 KSME와 NHPLEB의 요청에 따라 이뤄진 것이었다. 2004년부터 실기시험을 위한 경험을 쌓는 중이었으며, 한국 면허를 취득하고자 하는 해외 의사에 대해서 시행중이었다. 일부에서는 정부가 해외 의사들에 대한 장벽을 높일 것이라는 우려를 했다. 그러나 외국 의사들의 임상역량을 확실히 하기 위한 목적이었다. NHPLEB의 실기시험TFT는 2005년 12월 OSCE의 개요를 제시했다.

In June 2006, the Minister of Health and Welfare of the Korean Government declared that the skill test will be applied, starting with graduates in 2009. This means that the first Skill Test for Medical License will take place in late 2009 or January 2010. The Minister’s declaration was made at the request of the KSME and the NHPLEB. We have also had some experience with a skill test since 2004, which has been used for foreign doctors who want a Korean license [3]. Some people raised the possibility that the Government intended to create a barrier against foreign doctors coming to our country. However, it was introduced to ensure the clin- ical competence of foreign graduates. The Task Force Team for the Skill Test of NHPLEB prepared and pre- sented the outline of an OSCE in December 2005 [4].

 

 

개요

OUTLINE

다음과 같다.

The outline is as follows:

1. The Medical Licensing Examination will consist of Clinical Skills (CS) and Medical Knowledge (MK, including basic and clinical medical sci- ences) examinations. The examinee who passes the CS examination (September–November 2009) will be eligible for the MK examination (January 2010). 

2. The OSCE will have 12 stations (10 minutes per station). 

3. Of the 12 stations, six stations will have a stan- dardized patient (SP) and will assess clinical skills as well as communication skills and clinical rea- soning. Each station will take 10 minutes. 

4. Six stations are for procedural skills, such as sim- ple sutures, venous blood sampling, and measur- ing blood pressure. 

5. A center will have two sets of 12 stations and will run three cycles per day, which will cover 72 exam- inees per day. To examine up to 3,600 examinees a year, it will take approximately 50 working days. 

6. The assessor will be a professor or a physician with a checklist in each station. The cut-off level will be determined by the modified Angoff method.

7. For a single test day, 28 SPs (seven SPs ×2 turns/ day×2 sets) and 28 assessors will be needed.

 

Figure 2. Scheme of the objective structured clinical examination stations.

OSCE STATIONS

Applicants will spend 10 minutes in the long sta- tion, and 5 minutes in the short station. An additional 5 minutes will be for the interstation written exercise. Twelve applicants will be tested in each cycle. Six will start with long stations and six with short stations, with 120 minutes for a cycle and 5 minutes for a break.

For the attitudes and skill testing (long stations), we have developed 56 clinical situations The list of clinical situations or settings is now available to the medical schools and students, but the checklist will not be available (Table 1).

The applicants will be assessed on their compe- tencies of communication skills, interviewing skills, history-taking, brief physical examination, and order- ing laboratory tests. The assessor will be a professor or a physician who has been trained. The assessor will be at each station and will use a structured checklist.

For the short stations assessing basic procedural skills, we have chosen 40 items such as simple suture of laceration, rectal examination, Foley catheter inser- tion, application of splint (Table 2). The short station will be of 5 minutes duration.

The interstation exam is optional, and will be asso- ciated with the preceding long station. Questions will be related to the clinical situation presented by the SP, and will focus on decision-making, differential diagno- sis, further diagnostic plan, and patient management, for example. It is a written test and will take 5 minutes. It there is no interstation assessment, the applicant will take a 5-minute rest before the basic skill test.

TEST DAY SCHEDULE

The test center will have two sets of identical stations. Each set will run 3 cycles/day (morning, midday, afternoon). Each cycle will take 3 hours (180 minutes); 30 minutes for orientation before the test +120 min- utes for the actual test +5-minute break+25 minutes for changes.

The OSCE center will have two sets of 12 stations, running 3 cycles/set/day, and 12 applicants for a cycle. Therefore, the center can assess 72 applicants each day.

There are usually fewer than 3,600 applicants each year. Accordingly, we estimate about 50 test days are required between September and November.

SPS AND ASSESSORS

Each SP will work for half a day, i.e. an SP will be in the test for one half cycle, 18 applicants a day, two turns a day. Each cycle involves six long stations with an SP. Therefore, for each test day, 14 SPs are needed (six stations with one reserve SP×2 turns).

Twenty-six assessors (or raters) are needed each day. An assessor is present at each of the 12 stations, with one reserve assessor, and two turns per day.

 

 

---

Kaohsiung J Med Sci. 2008 Dec;24(12):646-50. doi: 10.1016/S1607-551X(09)70030-0.

OSCE for the Medical Licensing Examination in Korea.

Lee YS1.

Author information

• 1Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea. yoonslee@snu.ac.kr

Abstract

Objective structured clinical examinations (OSCEs) will be introduced in the Medical Licensing Examination in Korea next year. To evaluate the competency of new medical graduates, a written examination is not sufficient to test the clinical skills and attitudes of medical school graduates. The Korean Society of Medical Education and National Health Personnel Licensing Examination Board have been preparing for OSCEs to be included in the licensing examination for a number of years, following the declaration by the Minister of Health and Welfare, of the Korean Government. One center in Seoul will provide two identical sets of stations. The OSCE will have 12 stations. Six short stations will test procedural techniques and skills, and six long stations will feature standardized patients. The test items for the short stations and the clinical presentations of the long stations will be made available to applicants. However, the checklists will not be made available. It is hoped that theOSCE will raise the standard of competencies of new medical doctors and change clinical education in the medical schools.

PMID:

 

19251560

 

DOI:

 

10.1016/S1607-551X(09)70030-0

[PubMed - indexed for MEDLINE] 

Free full text