Abstract Title | Catch them early: Precepted OSCE reviews using guided self-reflection with faculty feedback


  1. Dr. Denise Souder
  2. Dr. Win May
  3. Dr. Julie Nyquist


OSCE and Standard Setting




Keck School of Medicine of the University of Southern California


Schon’s (1983) reflection-on-action and reflection-in-action provided the theoretical framework for students at the Keck School of Medicine (KSOM) to review one encounter from an Objective Structured Clinical Examination (OSCE) early in their third year.  In September 2011, the KSOM introduced an Intersessions Course, one week in the fall and one week in the spring, designed to enable learners to pause, reflect, and consolidate their varied clinical experiences.  A component of the fall 2011 Intersessions was an individual OSCE review session designed to foster self-assessment by having students watch one of their OSCE videos, complete a guided self-reflection form, and receive faculty feedback.


Individual student OSCE review utilizing self-reflection, a guided self-reflection form and faculty feedback is valued by the students and useful in identifying areas needing improvement.  Future studies are needed to determine how best to conduct this activity so that it can help further develop the reflective skills of third year medical students. 

Summary of Work

This study was conducted to determine (1) whether students utilizing OSCE video review with guided self-reflection and faculty feedback enabled them to identify learning points to be explored, and (2) to assess whether the students found the activity useful.

157 third year students participated in the fall 2011 Intersessions OSCE review.  Over the course of 3 afternoons, students met individually with 21 faculty for 30 minutes.  Each student and faculty watched one of the student's OSCE encounters with the student working through an OSCE self-reflection form.  Faculty provided verbal feedback to the students on their clinical skills.

Take-home Messages

OSCE review with guided self-reflection can assist student’s self-assessment of their clinical skills.

Summary of Results

92% of students identified one learning point (n=144).  Four identified themes emerged from their self-identified learning points: (1) improve patient-physician interaction skills; (2) improve time management; (3) develop better organizational skills; and (4) take a more complete history and perform a more thorough physical examination.  OSCE review was rated the most useful activity in the weeklong Intersessions course, 4.41 (SD = 0.83) on a 5-point Likert scale.   Amount of new information gained was rated as substantial, 3.95 (SD =1.12) on a 5-Likert. 


1.    Schon DA. (1983). The Reflective Practitioner: How Professionals Think in Action.  New York: Basic Books.

2.     White CB, Ross PT, Gruppen L.  Remediating students’ failed OSCE performances at one school: the effects of self-assessment, reflection, and feedback.  Acad Med 2009; 84(5):651-654.

3.     Mamede S, van Gog T, Moura AS, de Faria RMD, Peixoto JM, Rikers RMJP, Schmidt HG.  Reflection as a strategy to foster medical students’ acquisition of diagnostic competence.  Medical Education 2012; 46:464-472.


White et al. (2009) found that the combination of review, reflection, and self-assessment aided students in their future OSCE performance.  Mamede et al. (2012) had observed that structured reflection with actual patient cases was effective in helping students develop diagnostic competence.


OSCE Self-Reflection Form



Student Name: _________________________          Case Name:_____________________________


1.      What D/D or challenges would you be considering as you read the presenting situation?


1.      ___________________________

2.      ___________________________

3.      ___________________________



2. After reviewing your performance, what history questions would you add in addition to what you asked the patient?


  1. ___________________________________________________________
  2. ___________________________________________________________
  3. _____________________________________________________________


3. Provide up to 3 D/D or challenges based on your history.


1.      ___________________________________________________________

2.      ___________________________________________________________

3.      ____________________________________________________________




4. What PE maneuvers would you perform to rule in or rule out your differentials/ assess patient’s status?


  1. ____________________________________________________________
  2. _____________________________________________________________
  3. _____________________________________________________________

 5. What maneuvers were performed incorrectly or incompletely?


  1. _____________________________________________________________
  2. _____________________________________________________________
  3. _____________________________________________________________

 6. Re-rank your D/D or challenges after performing the physical examination.


1.   ______________________________________________________________

2.   ______________________________________________________________

3.   ______________________________________________________________




7. What patient education would be appropriate for this patient encounter?







8.  Did you observe that you

·made a personal connection with the patient

·gave the patient an opportunity to talk

·listened with undivided attention

·checked/clarified information

·encouraged the patient to ask questions

·adapted to patient’s level of understanding

·expressed empathy

·maintained a respectful tone

·discussed the patient’s concerns about  or expectations for treatment/prevention

·involved the patient in deciding upon a plan

·reviewed the next steps with the patient


9. Did you have any problems with:


a.       time management

b.      content knowledge


 10. What did you learn from this video review and self-reflection?



Summary of Work

Anonymous course evaluations provided quantitative and qualitative data for the OSCE review.  Simple statistics were used to analyze the quantitative data.  The learning points identified by students on the OSCE self-reflection forms were analyzed for themes using Grounded Theory.

Take-home Messages
Summary of Results

Student comments for usefulness and application of learning included the following:

“Precepted OSCE reviews are very useful.”

“Be more confident and calm down . .  I speak very quickly when nervous.”

“I will do a more thorough physical exam.”

“I will be more organized.”

“Take less notes with patients during OSCE.”





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