Abstract

Evaluating the educational impact of Direct Observed Procedural Skills (DOPS) on final year medical students

Author(s): Roderick McLeod, Gary Mires, Jean Ker

Introduction: there are several challenges in assessing health care professionals to ensure they are fit for practice. Changes in professional roles and regulatory requirements have identified the need to provide evidence of fitness to practice to ensure standards of care are delivered to patients. In respect to all graduate medical students, the UK General Medical Council (GMC) have identified a number of procedures foundation doctors should be competent in at the time of graduation. A major challenge is agreeing on what competent behaviour in practice is and how it can be measured. There is evidence to suggest that supervisor evaluations in the past have been unreliable [8] and several reports have identified a lack of rigorous testing of procedural clinical skills [9]. The Direct Observed Procedural Skills (DOPS) has been implemented a postgraduate level in medicine and has been designed specifically for the assessment of procedural skills [10].

Methods: a convenience sample of 15 final year medical students were assessed in relation to procedural skills on their clinical attachments in a simulated practice setting using the DOPS assessment tool. A semi-structured questionnaire, using a Likert scale with a series of open ended questions, was completed by participating students both after the clinical skills session and the DOPS assessment. The questionnaire was repeated after a 6 week interval to identify how the students’ practice had been influenced. Structured student focus groups were held 8 weeks after the skills assessment to explore barriers and perceptions of the quality of performance in relation to implementing standards of practice for procedural skills using DOPS.

Results: themes that emerged from the focus groups identified the impact as perceived by learners of using DOPS to provide evidence of competence. The students believed that there was a high value to being part of this assessment evaluation which was highly praised. They particularly valued immediate, and where appropriate, directive feedback. Content of their discussion also indicated that enhanced assessment and feedback processes could facilitate the benefit that students obtain at all levels of training. The general consensus was that future efforts should be made to introduce DOPS into the clinical setting. Findings suggest that the students considered that expert feedback was important. The positive comments are supported by the observation of the assessor who noted that the students’ procedural skills had developed during the sessions.

Conclusion: there are many different approaches taken in the assessment of procedural skills. This paper will provide some insights into the challenges and benefits of using DOPS with final year medical students.