Journal of Current Research in Scientific Medicine

: 2019  |  Volume : 5  |  Issue : 2  |  Page : 130--131

Utility of direct observation of procedural skills method in producing a competent medical graduate

Saurabh RamBihariLal Shrivastava1, Prateek Saurabh Shrivastava2,  
1 Vice-Principal Curriculum, Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Associate Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603 108, Tamil Nadu

How to cite this article:
Shrivastava SR, Shrivastava PS. Utility of direct observation of procedural skills method in producing a competent medical graduate.J Curr Res Sci Med 2019;5:130-131

How to cite this URL:
Shrivastava SR, Shrivastava PS. Utility of direct observation of procedural skills method in producing a competent medical graduate. J Curr Res Sci Med [serial online] 2019 [cited 2020 Apr 4 ];5:130-131
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Full Text

Dear Sir,

The ultimate goal of medical education is to empower students to meet the health needs of the general population.[1] In the field of medical education, assessment is as important as teaching–learning activities as it aids in deciding the extent to which students meet the minimum acceptable standards required for graduation.[1] The written examinations, which are conducted by default throughout the course, usually assess the cognitive domain as per Bloom's taxonomy or the “know” level in Miller's pyramid of skill acquisition.[1],[2] These conventional assessment methods fail to assess the higher skills, which are quite important for future professional performance.[1]

However, to ensure that students are competent enough to perform in real-life settings, workplace-based assessments have been proposed.[2] Direct observation of procedural skills (DOPS) method has been proposed to systematically assess practical skills through direct observation in authentic settings and provide feedback to the students regarding their performance.[2],[3] This method has been widely employed in competency-based medical education as it assesses the “does” level of Miller's pyramid.[3]

Compared to conventional methods of assessment, the validity of DOPS method is higher because it provides more emphasis on the task/skills being assessed. In addition, being a student-centered approach, it plays a significant role in self-directed learning, as the rubrics of milestones designed for the given entrustable professional activities helps the student plan their learning in such a way that they can move from novice stage to the expert.[3] The method gives adequate scope for assessing the communication skills in addition to psychomotor domain of the students and planning remediation in the areas of deficiency.[1],[3] The method provides remediation for those students who are in need.[3] The students are assessed with the help of a checklist, and the assessment can be made totally objective by designing appropriate rubrics for each of the domain which is being evaluated.[4]

Moreover, the tool can even have the component of reflections, wherein the learners reflect upon the entire process and write their specific learning which could potentially act as a medium for promoting deep learning.[4] However, the reliability of the tool could get compromised in the absence of validated rubrics.[2] In addition, the tool cannot be considered as needs-driven unless both learner and trainer have an understanding about the instrument and its scope in improving the performance of the learner.[2] In case of improper supervision, the learners will not take assessment seriously and may not even follow the given feedback.[2],[3]

Moreover, the process of developing and validating a tool is time-consuming and often regarded as the extra workload by the faculty members.[2],[4] In addition, practical problems of difficulty in its design and development, being resource-intensive, necessity for better faculty strength, unfamiliarity of teachers with the procedures, reluctance of faculty members, conduction of periodic assessments, discord between faculty and student intentions, and lack of motivation toward using the new assessment method have also affected the entire process.[5],[6] From the students' perspective, poor knowledge about DOPS or stress/anxiety toward a new assessment method has been identified as a key barrier.[5],[6]

However, considering the practical merits associated with DOPS, and considering the fact that we can assess all four domains in learning, it should be a must for both undergraduate and postgraduate teaching. Most of the identified challenges can be tackled through the support of administration, active involvement of the Medical Education Unit, and sensitization of the involved stakeholders.[1],[4] Furthermore, involvement of an expert who has a successful experience of implementing the tool and has documented evidence to show the utility of the tool can help a lot.

In conclusion, DOPS method provides multiple opportunities for the students to enhance their learning through feedback and reflections, while it assists the faculty members to systematically monitor the growth of the learner through periodic assessments.

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Conflicts of interest

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3Lörwald AC, Lahner FM, Nouns ZM, Berendonk C, Norcini J, Greif R, et al. The educational impact of mini-clinical evaluation exercise (Mini-CEX) and direct observation of procedural skills (DOPS) and its association with implementation: A systematic review and meta-analysis. PLoS One 2018;13:e0198009.
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