The perceptions and experiences of chiropractic students with regards to objective structured clinical examinations at a South African University of Technology

Abstract

BACKGROUND A vast amount of literature has contributed to the topic of students’ perceptions and experiences of objective structured clinical examination (OSCE). Many of these studies address the challenges that students face during those examinations, but few discuss the perceptions and experiences that university students may face before, during, and after the OSCE. In the realm of chiropractic education, abundant literature exists about the chiropractic field, as well as the curriculum and the accreditation of chiropractic education around the world. Noteworthy, unlike other healthcare professional programmes, literature regarding the perceptions and experiences of the chiropractic student with regard to the OSCEs in the course, and how that experience affects their clinical competence in the programme and future is scarce. This study recorded the perceptions and experiences of chiropractic students at a selected South African university of technology regarding the format, use and testing of the OSCE. AIM To explore the perceptions and experiences of chiropractic students towards the OSCE at a South African university of technology. METHOD A qualitative, exploratory, descriptive approach was utilised for this research. A purposive sample of 20 chiropractic students who have been examined in minimum of three OSCEs were interviewed. Their perceptions and experiences regarding the OSCEs were obtained through semi-structured interviews. A total of three key questions, each relating to how students feel before, during, and after the OSCE process were used to stimulate a discussion. The data were recorded electronically and thereafter transcribed verbatim. Thematic analysis was used to interpret the data. RESULTS The participants indicated that, for the most part, the OSCE is valued but, to some extent, could be tailored closer to the chiropractic scope of practice. This meant that while they were taught adequately, they were not fully prepared for the OSCEs as they did not adequately simulate real world clinical scenarios in the field of chiropractic. The examiners demeanour also played a substantial role in the participants’ experiences of the OSCEs. The participants indicated that their experiences were negative, stressful, and full of anxiety due to the format of the OSCEs, with its time constraints and difficulties with the examiners who were testing them. Another factor which contributed to the participants’ experiences of the OSCEs was the way they were being tested. The participants felt they were being examined differently to the way in which they were taught as many of the examiners were external clinicians. In contrast, the participants also mentioned that they benefitted from the OSCEs with regard to learning how to work well under pressure and building confidence, allowing them to be better prepared for clinical practice. The participants recommended that the OSCEs should be closer aligned with the chiropractic scope of practice, that the format of the OSCE be changed, and the time limit per a station increased. CONCLUSION This is the first South African study to document the perceptions and experiences of chiropractic students regarding the OSCEs at a South African university of technology. These perceptions and experiences were based on a variety of internal and external factors in relation to the university, chiropractic course, and examiners of the OSCEs. While the participants acknowledged and appreciated the positive aspects of the OSCEs, they provided constructive feedback on different aspects to help improve the experiences of the OSCE for chiropractic students. For many of the participants, the overall experience of the OSCEs was negative and they felt it could be significantly improved in the chiropractic course. It is advisable for educational institutions and stakeholders within chiropractic education to leverage the findings of this study to improve chiropractic education in South Africa.