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Using the OSCE to assess medical students’ communication and clinical reasoning during five years of restricted clinical practice

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dc.contributor.authorArmijo-Rivera, Soledad
dc.contributor.authorZamorano Saavedra, Catalina
dc.contributor.authorVicencio-Clarke, Scarlett
dc.contributor.authorBehrens Pérez, Claudia
dc.contributor.authorPérez-Villalobos, Cristhian
dc.date.accessioned2026-07-22T21:12:26Z
dc.date.available2026-07-22T21:12:26Z
dc.date.issued2025
dc.description.abstractBackground Objective and Structured Clinical Examination (OSCE) is a widely used evaluation method for health profession students. In Chile, physicians OSCEs have incorporated clinical reasoning and patient-centered communication assessment since 2015. The overall impact of the COVID-19 pandemic on undergraduate medical clinical practice remains unknown, in particular whether this context disproportionately affected lower-income regions, as was the case analysed in this study. Aim This research compares the OSCE patient-centered communication and clinical reasoning results among five cohorts of intermediate-level medical students with restricted clinical practice in Chile. Methods We designed an observational study analyzing five cohorts of fourth-year medical students with different clinical practice opportunities, with 3rd to 4th-year progression analysis in two cohorts. Adaptations to compensate lack of clinical practice hours include high-fidelity simulation and theoretical discussion of clinical cases, as well as formative OSCE at third-year level in two cohorts. Communication in OSCE was assessed using the Communication Assessment Tool (CAT) and Clinical Reasoning (CR) with a register form (that includes a global score, History Taking, Differential Diagnosis, and Therapeutic Plan subscores). Descriptive statistics and central tendency measurements were applied to analyze CAT and CR scores, along with Kruskal-Wallis tests and Wilcoxon’s test for paired sample analysis. Findings The 2018 cohort shows the lowest results in both variables although it was the cohort with more clinical practice opportunities. The higher CAT result was in the 2021 cohort, while the 2022 cohort exhibited a significantly higher CR score (p < 0.05). There is a linear tendency to grow over the years for both measures. The 2023 cohort shows significant improvement between third-year and fourth-year OSCEs in all items of CAT and a detriment in CR, while the 2022 cohort shows a significant increment in CR and four items of CAT (p < 0.05). Conclusion The students with fewer hours of clinical practice showed similar CR and communication results to the prepandemic group, probably because of the adaptations implemented. Simulation was an effective alternative.
dc.description.versionVersión publicada
dc.format.extent10 p.
dc.identifier.citationSoledad, AR., Catalina, Z.S., Scarlett, VC. et al. Using the OSCE to assess medical students’ communication and clinical reasoning during five years of restricted clinical practice. BMC Med Educ 25, 608 (2025). https://doi.org/10.1186/s12909-025-07210-x
dc.identifier.doihttps://doi.org/10.1186/s12909-025-07210-x
dc.identifier.urihttps://hdl.handle.net/11447/10898
dc.language.isoen
dc.titleUsing the OSCE to assess medical students’ communication and clinical reasoning during five years of restricted clinical practice
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourceBMC Medical Education
dspace.entity.typePublication

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