Skilled task teaching and assessment

Teaching and OSCE assessment of core clinical skills requires large resources in time and staff. Therefore, ensuring efficient and effective teaching that produces quantifiably competent students is important. This study compared the content of an 'Advanced Life Support (ALS) Course' with the medical undergraduate curriculum at this institution; it examined the OSCE resuscitation station for medical students to identify common errors where teaching could be improved; and finally it compared the resuscitation station with other skilled task stations. The written curriculum for the 'ALS' course and undergraduates was scrutinized for content and duration. Performance in the resuscitation station was analysed by dividing it into 20 separate skilled tasks marked individually. This station was compared with stations on chest and abdominal examination, and fundoscopy. Undergraduate resuscitation teaching exceeded the 'ALS' course in duration, including theoretical and practical teaching, and in depth of knowledge. During the practical resuscitation OSCE several skilled tasks were identified as deficient. The results of the resuscitation OSCE were better than those from the other skilled task stations. Students perform to a higher standard in OSCE stations that assess ability to deal with stressful situations. Their performance in the simulated environment of the OSCE is of a high standard and may in part be due to the fact that the station is omnipresent, without cross-compensation of marks. Formal 'ALS' courses are expensive and, as this study demonstrates, unnecessary given the high standards attained.