Objectively Structured Practical Examination (OSPE) The Professional Medical Journal

https://doi.org/10.29309/TPMJ/2024.31.07.8189 www.theprofesional.com
2024, Volume, 31 Issue, 07

ORIGINAL ARTICLE
Objectively Structured Practical Examination (OSPE) in traditional examination
system versus integrated modular system: Perception of teaching faculty at a
Public Sector Medical College of Punjab.
Menahal1, Muhammad Junaid Iqbal2, Muhammad Wasim Zafar3, Wajeeha Batool4, Abdul Ghaffar5, Rameen Zahid6

Article Citation: Menahal, Iqbal MJ, Zafar MW, Batool W, Abdul Ghaffar, Zahid R. Objectively Structured Practical Examination (OSPE)
in traditional examination system versus integrated modular system: Perception of teaching faculty at a Public Sector Medical College of
Punjab. Professional Med J 2024; 31(07):1012-1017. https://doi.org/10.29309/TPMJ/2024.31.07.8189

ABSTRACT… Objective: To access the perception of teaching faculty regarding traditional OSPE and integrated modular
OSPE. Study Design: Cross-sectional study. Setting: Sahiwal Medical College, Sahiwal. Period: February 2024 to March
2024. Methods: To collect data on the perceptions of the teaching faculty (n=30) (who were performing duty as examiners
in first year professional examination), towards the newly introduced mode of assessment; integrated modular OSPE (which
consists of OSPE, OSVE, PERLs and OSCE stations). Convenient sampling technique was used and a validated questionnaire
was distributed as Google form on Whatsapp. Data was analyzed through SPSS version 20. Results: According to the
teaching faculty, out of which 11(36.7%) were males and 19(63.3%) were females, integrated modular OSPE is relatively
lengthy and stressful for the students 25(83.3%), while traditional OSPE is comparatively more transparent, fair, objective
17(56.7%) and in line with the curriculum 19(63.3%). Furthermore, traditional OSPE is comparatively easier to pass 23(76.7%),
easier to conduct 21(70%) and also easier for the students 24(80%). According to teaching faculty, traditional OSPE has low
probability of bias comparatively 20(66.6%). Conclusion: As per the perception of the selected teaching faculty, traditional
OSPE is comparatively a better mode of assessment.

Key words: Perception, Traditional OSPE, Integrated Modular OSPE, Feedback.

INTRODUCTION Structured Clinical Examination). Additionally, a

Assessment drives learning. Undergraduate study was carried out in India to determine which
medical institutions conduct periodic examinations viva pattern would be most appropriate. The
to evaluate students’ knowledge and skills. findings indicated that the intra-group percentage
Medical educators have always been concerned coefficient of variance values gradually increased
about the quality of student evaluation, and in the following order: unstructured practical viva
various evaluation methods have been introduced assessment (UPA %age, 18.25) < structured
to improve the reliability and objectivity of medical written theory examination (STE%age, 47.26) <
education.1 Objective Structured Practical structured theory viva voce (SVV %age, 63.91).
Examination (OSPE) and Objective Structured As a result, unstructured practical viva evaluation
Clinical Examination (OSCE) are practical/clinical UPA%age is less discriminating than structured
examination techniques that have been used in theory viva voce (SVV%age).2 For the formative
practice in Pakistan and its neighboring countries assessment of undergraduate medical students,
for many years. Various assessment methods the Objective Structured Viva Examination
that have been used for medical students in (OSVE) is a more effective instrument than the
Pakistan for many years include written exams, traditional oral viva examination (TVE). Currently,
viva voce exams, OSPE (Objective Structured the Objectively Structured Viva Exam (OSVE)
Practical Examination), and OSCE (Objective can be utilized in addition to the Traditional Viva
1. Undergraduate 4th Year MBBS, Student, Sahiwal Medical College, Sahiwal. Correspondence Address:
2. MBBS, MHPE (sch), Demonstrator Medical Education, Sahiwal Medical College, Sahiwal. Menahal
3. MBBS, MPH, Demonstrator Anatomy, Sahiwal Medical College, Sahiwal.
Sahiwal Medical College, Sahiwal.
4. MBBS, M.Phil (Microbiology), Senior Demonstrator Pathology, Sahiwal Medical College, Sahiwal.
5. MBBS, MCPS (Gynae & Obs) Trainee, Senior Demonstrator Pathology, Sahiwal Medical College, Sahiwal. step.menahal@gmail.com
6. Undergraduate 4th Year MBBS, Student, Sahiwal Medical College, Sahiwal.

Article received on: 18/03/2024

Accepted for publication: 16/05/2024

1012 Professional Med J 2024;31(07):1012-1017.

Objectively Structured Practical Examination (OSPE) 2

Exam (TVE) to improve results. This can be done that OSPE is a better assessment method.
by combining the two techniques.3 Researchers According to the results of a study conducted
found that students’ mean scores on the OSVE in India in 2016, the average score obtained by
were higher than their TVE scores. TVE had mean students in OSPE (73.0 ± 9.8%) is higher than
scores of 21.4 ± 4.5 out of 30 while OSVE had the average score in classical/traditional practical
mean scores of 24.7 ± 5.8 out of 30.3 Similar exam (70.7 ± 9.6%). It was shown that the results
findings were found in a study on viva patterns, were statistically significant and there was no
which indicated that 83% of students found inter-examiner variation observed in OSPE.11
SVVE (structured viva voce examination) to be
generally acceptable and that nearly 66% of them Apart from previous assessment modes
liked it in comparison to TVVE (traditional viva including traditional objectively structured
voce examination).4 Other evaluation methods practical examination, traditional via examination,
mainly include OSPE (Objective Structured Live objectively structured practical exam and
Examination) and OSCE (Objective Structured objectively structured viva exam, a new
Practical Examination). OSPE is a practical methodology was introduced this year (2024)
examination system that is not only objective but by the University of Health Sciences (UHS) in
also reliable and valid.5 Although OSPE assesses Punjab, Pakistan, namely integrated OSPE as
students’ knowledge, OSCE primarily assesses a mode of assessment for the undergraduate
students’ clinical skills. 1st year MBBS students who were taught by
modular system. Regarding the pattern of
In a 2020 study in India, a specific group of integrated OSPE that was followed this year
students was assessed using both traditional is concerned, in it there were all observed
practical exams and OSPE. The results showed stations (in which students had to perform and
that there was a significant difference in OSPE their performance was being evaluated by the
scores compared to the regular/traditional teachers). In the professional examination of
practical exam. Therefore, this information first year there were separate integrated OSPE
indicates that the OSPE format was better exam for each of the three modules/blocks.
accepted by students and also led to improved The integrated OSPE examination setting was
average grades.6 OSPE/OSCE provides an such that there were total 12 stations in each
opportunity to assess the clinical/practical OSPE examination, out of which 8 stations were
application of knowledge. Structuring questions observed OSPE (objectively structured practical
and emphasizing objectivity are the main goals of examination) stations, 2 stations were observed
OSPE/OSCE7, and furthermore, the OSPE/OSCE OSVE (Objectively structured viva exam) stations,
system is the best tool for assessing basic science one station of OSCE (Objectively structured
skills.8 In a study conducted in 2015 to evaluate clinical exam) and PERLs (Professionalism,
the newly introduced OSCE/OSPE at that time, ethics, research & leadership skills). In our study,
it was established that it has numerous discrete we collected data on teachers’ perceptions.
advantages. As it stands, it would be realistic Perception based evaluation makes it possible
to expect it to be incorporated into university to evaluate the strengths and weaknesses of the
assessment schedules and students’ daily teaching method, eliminate difficulties and modify
evaluations to improve clinical competency.9 In the program accordingly.12
contrast, another study found that 44% of faculty
did not agree with the replacement of the Practical METHODS
Table with OSPE/OSPE and the implementation of After having ethical approval from institutional
OSPE/OSCE in the comprehensive assessment, ethical review board (75/IRB/SLMC/SWL) (1-2-
but more than 60% of faculty agreed, OSPE/ 24), a comparative cross-sectional study was
OSPE is mentally and physically exhausting and conducted from 1st February, 2024 to 10th March,
requires faculty and time to create and administer 2024 at Sahiwal Medical College, Sahiwal (which
the exam.10 However, various studies have shown is a public sector medical college of Punjab,
Professional Med J 2024;31(07):1012-1017. 1013
Objectively Structured Practical Examination (OSPE) 3

Pakistan). Convenient sampling technique was RESULTS

used (sample size=29). We collected data from Total 30 study participants from the teaching
the teaching faculty (n=30), only those teachers faculty were included in this study, out of them
were included in this study who were performing 11(36.7%) were males and 19(63.3%) were
duty as examiner in the 2024 OSPE examination females.
center at our institute. Since all the stations
in the integrated OSPE were observed so we
Valid Cumulative
included only those teachers who were acting f %age
Percent Percent
as examiners in the OSPE at our respective
Anatomy 9 30.0 30.0 30.0
public sector medical college and asked them for
their perception regarding the traditional OSPE Biochemistry 6 20.0 20.0 50.0
versus integrated modular OSPE. A validated Medical
5 16.7 16.7 66.7
questionnaire13 was provided to them via Google Education
form. Data was collected and entered into excel. Physiology 10 33.3 33.3 100.0
Data was analyzed via SPSS version 24. The Total 30 100 100
sample size14 was calculated as follows;
Sample size n = [DEFF*Np(1-p)]/ [(d2/Z21- Table-I. Shows participants’ division on the basis of
the departments they belonged to.
α/2*(N-1)+p*(1-p)]
SAMPLE SIZE IS 28 ON 80% CI

Traditional OSPE Integrated Modular OSPE

Which one is lengthy and stressful for students? 5(16.6%) 25(83.3%)
The questions asked in the stations were more appropriate
19(63.3%) 11(36.7%)
and in line with the curriculum in?

Which one is more transparent, fair and objective as

17(56.7%) 13(43.3%)
compared to traditional practical examination?
Comparatively which one is easier to pass? 23(76.7%) 7(23.3%)
Which one is comparatively more useful and relevant
19(63.3%) 11(36.7)
to develop the psycho-motor skills of students?

Which of the following mode of assessment reduces the

20(66.6%) 10(33.3%)
chance of bias by examiners?

Which one is comparatively more efficient mode of

16(53.3%) 14 (46.7%)
assessment?
Which mode of assessment is easier to conduct? 21(70%) 9(30%)
According to you, which one is easier for the students? 24(80%) 6(20%)
Table-II. Perception of teaching faculty regarding Traditional OSPE versus integrated modular OSPE

More Efficient Mode of Assessment

Total P-Value*
Traditional OSPE Integrated Modular OSPE
Anatomy 2 (22.2%) 7 (77.8%) 9
Biochemistry 4 (66.7%) 2 (33.3%) 6

Department Medical Education 1 (20%) 4 (80%) 5

Physiology 9 (90%) 1 (10%) 10 0.006

Total 16 (53.3%) 14 (46.7%) 30

Table-III Comparison of the answers regarding which is the more efficient mode of assessment. p value* is
calculated by Fisher’s Exact test. A significant correlation (p value=0.006) was found between perception of the
research participants and the departments they belonged to.

1014 Professional Med J 2024;31(07):1012-1017.

Objectively Structured Practical Examination (OSPE) 4

DISCUSSION The majority 17 (56.7%) of the teachers had the

The criterion for a good examination depends view that traditional OSPE is comparatively more
on a lot of factors (including objectivity, reliability, transparent, fair and objective as compared to
practicability and validity) which are always taken traditional practical examination. On the other
under consideration by the DME (Department of hand, 13(43.3%) responded that integrated
Medical Education). This year, as the students modular OSPE is comparatively more fair and
were exposed to the integrated modular OSPE transparent. In a study done in 2016, it was
(which consists of OSPE, OSVE, PERLs and observed that Forty-six (74.2%) of the students felt
OSCE stations) for the very first time, the data that OSVE is less time consuming as compared
was collected from the teaching faculty to to the TVE. 45 (72.6%) of the students were of the
assess some significant parameters of integrated opinion that OSVE had a wider coverage of the
modular OSPE in contrast to traditional OSPE. In content.3
2015 a study was conducted in India to assess
students’ perception regarding OSPE in their Comparatively traditional OSPE is easier to
study most of the participants (82.4%) agreed that pass according to the majority 23 (76.6%) of the
OSPE is a better method of examination than the responses. Only 7 (23.3%) examiners considered
conventional/traditional practical examination. integrated modular OSPE as comparatively
The majority of the participants (77.0%) said that easier to pass. Traditional OSPE as per majority
the OSPE covered wide range of knowledge than 19 (63.3%) of the respondents, is comparatively
the conventional practical examination.1 more useful and relevant to develop the psycho-
motor skills of the students while a small number
Total 30 individuals participated in the study, we 11 (36.7%) examiners/teachers/respondents
included those teachers who were conducting considered integrated modular OSPE as more
OSPE this year as examiner. According to useful for developing psycho-motor skills of the
teaching faculty, 25 (83.3%) responded that students.
integrated modular OSPE is comparatively
lengthy and stressful for the students while The chance of biased marking by the examiner
5(16.7%) considered traditional OSPE as lengthy. is comparatively less in traditional OSPE as per
majority of responses 20 (66.6%) while only 10
The questions asked in the stations were more (33.3%) were of the opinion that the chance of bias
appropriate and in line with the curriculum is less in integrated OSPE. In a study conducted in
in traditional OSPE according to the majority 2016 in India, the results showed that above 90%
19(63.3%) of the respondents while 11(36.7%) of students felt that OSPE was more practically
were of the view that integrated modular OSPE oriented examination with less chances of bias.3
is more in line with the curriculum. In a study OSPE eliminates examiner bias.5
conducted in 2016, results showed that (17.7%)
respondents felt that TVE (Traditional Viva Exam) According to majority 16 (53.3%) of our
covered the course better, while the remaining teaching faculty, overall traditional OSPE is
6 (9.7%) were uncertain about it.6 Also a recent comparatively more efficient mode assessment.
study concluded that structured viva exam SVE While 14 (46.7%) teachers considered OSVE
(structured viva exam) may be considered as a as more efficient mode of assessment. In a
better tool of assessment as it decreases bias, study conducted in 2017 in Pakistan, student
reduces inter-examiner variation and encourage perception was assessed and it was almost all
students to prepare well for viva.15 Similarly, in a the students agreed that Integrated Performance
study conducted in 2014, results showed that, Assessment was better than traditional OSPE.17
majority of students (91.6%) felt that structured but in comparison of responses by individual
viva is fairer than conventional viva. Only 61.6% departments, a significant correlation was found
students felt that structured viva is easier to score (p-value=0.006) on applying Fisher’s Exact test.
than conventional viva.16 Anatomy department 7(77.8%) and Medical
Professional Med J 2024;31(07):1012-1017. 1015
Objectively Structured Practical Examination (OSPE) 5

education department 4(80%) were more in favor 3. Radhika G, Dara AK, Varalaxmi KP, Bhavani C.
of integrated OSPE while teachers of Biochemistry Perceptions of the introduction of objective
structured practical examination (OSPE)/objective
department 4(66.7%) and Physiology department structured clinical examination (OSCE): A pilot
9(90%) were preferring traditional OSPE. study carried out in Government Medical College,
Ananthapuramu, Andhra Pradesh, India. Journal
Traditional OSPE mode of assessment is to be of Dr. NTR University of Health Sciences. 2015 Jul 1;
4(3):145-9.
more easy to conduct by majority 21(70%) of the
teachers. 9 (30%) teachers were of the opinion 4. Dhasmana DC, Bala S, Sharma R, Sharma T, Kohli
that integrated modular OSPE is easier to conduct S, Aggarwal N, Kalra J. Introducing structured
in comparison to OSPE. viva voce examination in medical undergraduate
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CONFLICT OF INTEREST faimer.org/education/fellows/abstracts/06adome. [Last
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of objective structured viva examination (OSVE) as
This research received no specific grant from any
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funding agency in the public, commercial, or not- medical students in forensic medicine. Sch J App
for-profit sectors. Med Sci. 2016 Nov; 4:3859-62.
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AUTHORSHIP AND CONTRIBUTION DECLARATION

No. Author(s) Full Name Contribution to the paper Author(s) Signature
1 Menahal Conception and design of work,
results compiling and data analysis.
2 M. Junaid Iqbal Conception and design of work,
supervision and revising it critically for
important intellectual content.
3 M. Wasim Zafar Data collection and analysis.

4 Wajeeha Batool Final approval of the version to be

published.
5 Abdul Ghaffar Analysis and interpretation, help in
write up of the article.
6 Rameen Zahid Data analysis and write-up of the
article.

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