Medical education can be basically considered an apprenticeship, because students learn their clinical skills by doing and repeating, often in simulated, low-pressure environments.
Their clinical competence is then assessed, which is an essential requirement of health professional education.
Since its introduction in 1975, the Objective Structured Clinical Examination (OSCE) has become a standard method of assessment that all medical students (both undergraduate and postgraduate) have to pass in order to qualify.
The most reputable medical schools in the United Kingdom, United States, and Canada now use the OSCE as the standard mode of assessment of clinical skill competency.
OSCE can be described as a timed examination in which medical students interact with a series of simulated patients in stations with varied scripts that may involve history-taking, physical examination, counseling or patient management.
This method measures student's ability to follow precise checklists while completing a focused history and physical exam and maintaining a patient-provider conversation in a short time.
Although OSCE is intended to teach students physical exam skills in a low-pressure environment, it can actually become a really stressful experience that puts a lot of pressure on medical students who might feel underprepared and inexperienced.
The standard method of preparation for OSCE exam is to get a textbook and read through the cases. It may not be that efficient to quiz yourself with the checklist in front of you, so many students practice together with their colleagues, either in person or via video chat.
Practicing the interaction with standardized, simulated patient, while preparing for the OSCE clinical medical exams, became a lot easier nowadays thanks to mobile technologies.
Clinical Exam app is designed to help medical students test and improve their practical clinical skills in order to pass their OSCEs, including MBBS, PLAB, USMLE Step 2 Clinical Skills, AMC Clinical Examination, and more.
Clinical Exam app provides clinical cases and mark schemes allowing students to simulate many different physical clinical examination scenarios in the format of Objective Structured Clinical Examinations (OSCEs).
The app provides 80 clinical cases covering cardiovascular, respiratory, abdominal, neurological, neck & thyroid, breast and musculoskeletal systems.
The app's interface is straightforward and easy to use. Upon opening, you'd be presented with a random case scenario. The cases can also be browsed by body systems.
Clinical Exam app is intended to be used in the context of a practical exam scenario that involves an examiner (teacher or instructor), a patient (with a particular condition), and a candidate (student). The roles of the examiner and the candidate are of course reserved for students who practice together.
So, how it works?
Upon selecting a specific case, an appropriate mark scheme is opened alongside a countdown timer. The examiner starts the timer and observes the candidate while they go through the examination of a simulated patient, ticking boxes to award marks as candidate completes required tasks.
Ticking boxes sometimes may reveal additional information regarding a particular task, allowing candidates to comment on that information.
Each case includes general tasks, such as washing hands, introduction to the patient, gaining consent, placing a patient in the adequate position, inspection tasks, such as inspecting environment and patient's general appearance, as well as case-specific tasks.
For example, the examination of facial nerve palsy in a 50-year old patient would include general tasks, along with inspection of the face and cranial nerves, ordering the further examination, and concluding the case with summarized findings, etiology, and correct diagnosis.
Or, the examination of suspected appendicitis in an 18-year old patient would require a candidate to go through required tasks such as inspecting abdomen, including palpation, percussion, and auscultation, as well as inspecting other other parts of the body (to exclude other possible causes).
The countdown timer is set to 10 minutes by default, however, this can be changed in the app's settings, which is useful because different OSCE stations may use different times.
Users can also set a one-minute alarm before the end of the exam that will alert them that they are running out of time.
At the end of the exam, the examiner provides the score to the candidate, allowing them to compare their score with previous performances, or to retry the case.
The selection of cases in Clinical Exam app is really good, with the clinical findings trying to guide the users toward a specific condition. However, there are several things that could be improved.
First, the app is supposed to be used by students, at least two, who would act as an examiner and a candidate. Taking that into consideration, cases need more detailed patient history, as they are somewhat vague currently. It probably wouldn't be a problem if a seasoned clinician poses as the examiner, but in reality, students are supposed to take this role as well.
The mark schemes also don't provide detailed information about the exams and particular tasks as they should.
The app would be significantly better if users, particularly those playing candidates, have the ability to add notes to each case, allowing them to record additional information about the exam to improve their clinical skills.
Finally, Clinical Exam app is only available for iOS, which is pity knowing how many medical students use Android phones and tablets.
Overall, Clinical Exam is a useful educational app for all medical students looking for a method to test their knowledge and improve their clinical skills when preparing for OSCE exams.
Benefit: Medical students preparing for clinical medical exams, such as USMLE Step 2 Clinical Skills, MRCP PACES, PLAB, and more