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Framework for utilising moulage in OSCEs: taking authenticity to the next level

Oral Presentation 4
Dr Bilal Korimbocus, Ms Helen Wilson, Ms Ãine McGuckin, Prof Gerry Gormley

Framework for utilising moulage in OSCEs: taking authenticity to the next level

Objective Structured Clinical Examinations (OSCEs) are commonly used as a method of assessment in health profession education. They espouse to facilitate the fair assessment of behavioural skills and competencies. Whilst “real patients” may act as cases in OSCE stations, more often OSCE stations draw upon simulation principles and techniques to “create” clinical scenarios. Whether working with Simulated Participants (SPs) or manikins, simulation has a lot to offer in OSCE station development. However, a range of conditions are under-represented in OSCEs given the challenge of creating the clinical features of these conditions (e.g. dermatological conditions and wound assessment). Moulage, the ability to harness special effects techniques to present a wide range of clinical signs, has the potential to create such clinical features.

Given the challenges of organising OSCEs (i.e. the need for consistently similar scenarios for large cohorts of students) guidance is required to optimise the effective use of moulage. In this conceptual presentation, we will present a framework, developed by a multi-professional team, which provides guidance in how best to utilise moulage in OSCEs.

We have developed a framework that provides practical guidance on the effective use of moulage in OSCEs. We have provided a pathway for incorporating moulage into OSCEs from the development and co-production stage through to the piloting and contingency planning stage, and finally the post-OSCE evaluation and quality improvement stage.

Key elements include: the alignment of moulage to the assessment objective(s) of the OSCE station, and early feasibility checks for appropriateness of moulage in OSCEs. We noted the importance of considering diversity issues and how moulage can act as a potential trauma trigger for SPs. Practically, this framework highlights steps to ensure: the durability of moulage with multiple examinations, the ease of application, financial costs, and the training required (both for the SPs and the moulage artists) to ensure the effects are standardised and realistic. Other practical considerations included: the time required for application and removal for the moulage as well as the provision of equipment for the same.

This presentation will capture the important elements of this framework and use three case studies to illustrate these principles in action (melanoma, Lyme disease and self-inflicted wrists wounds). Such framework will be of benefit to those involved in OSCEs, or keen to get involved, in enhancing authenticity in a wide range of potential OSCE stations.