Objective structured practical examination (OSPE) for formative assessment of medical undergraduates in Biochemistry

Background Assessment is a process that includes ascertainment of improvement in students' performance over time, motivation of students to study, evaluation of teaching methods and ranking of students. Despite the new competency-based medical education, assessment remains a largely untouched aspect. Most medical colleges still follow the conventional practical examination (CPE) methods that raise concerns about examiner variability, standardisation, and assessment uniformity. Objective structured practical examination (OSPE) includes objective testing through direct observation, knowledge assessment, comprehension, and skills. We studied the feasibility and acceptability of OSPE as a method of formative assessment of practical skills in biochemistry and to determine faculty and student perception of OSPE as an assessment tool. Methods Phase 1 MBBS students of the 2020-21 batch of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, were divided into two groups of 85 students each. The first group was assessed for Competency-1 through CPE and the second group was assessed for the same competency through OSPE. These students were then crossed over. The first group was now assessed for Competency-2 through OSPE and the second through CPE for the same competency. The process was repeated for the third and fourth competencies. Thus, two crossovers were performed with four OSPEs and their corresponding CPEs. The mean scores of the students were compared using both assessment methods, using an unpaired student 't' test. Bland-Altman analysis was done to compare differences between OSPE and CPE. Student and faculty feedback was collected on a 5-point Likert scale for close-ended questions, and a thematic analysis of open-ended questions was done. Results When assessed with OSPE, students' mean scores were found to be significantly higher (p<0.001) than CPE. Cronbach alpha of the questions administered had high internal consistency with a score of 0.83 for students and 0.89 for the faculty. Conclusion OSPE can be used for formative assessments in undergraduate medical students in biochemistry as it is feasible and acceptable to both students and faculty and brings a level of objectivity and structure to the assessment process.