Objective Structured Clinical Examination (OSCE) to Assess Student Learning in Transfusion Medicine

According to the National Competency-Based Catalog of Learning Objectives for Medicine (NKLM), medical students should know how to perform a transfusion including bedside test and what to do in cases of a transfusion related emergency. The objective of this teaching project was to assess the effectiveness of different teaching formats in preparing students for the state board exams.

Our institute teaches transfusion medicine as part of the surgery course to students in the 9th semester of medical school. The current teaching format involves a seminar about basic skills in transfusion medicine and a visit to the donation center and blood bank (Control group). To assess critical skills in transfusion medicine, we developed four objective structured clinical examination stations (OSCEs) that simulated the transfusion process from identifying patients for red blood cell transfusion through interpreting results from the blood bank to preforming a transfusion and monitoring the patient (OSCE group). Students were evaluated based on their performance during the OSCEs and completion of a multiple choice questionnaire (MCQ).

To gauge how well students performed overall on the OSCE stations, we looked at their average performance over the entire OSCEs as a whole and found that all 10 students passed the threshold of 60%. Only one student demonstrated a strong performance in all four OSCEs while three students performed at or below the 60% cutoff in single OSCEs indicating that we were able to distinguish low performing students from high performing students. As a group, the students performed well in OSCEs that dealt with indications for a transfusion and patient interactions, and comparatively weaker in OSCEs that focused on lab results and the actual transfusion. The hands on tasks during the OSCEs seemed to improve student performance on the MCQ where the control group in turn underperformed in blood group and compatibility testing.

Considerable insight was gained using the four OSCE stations to assess student performance across the many different tasks required for an red blood cell transfusion. Most notable was the lack of student knowledge on red blood cell allo- and autoantibodies and how these are tested during the pretransfusion screening.

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