A COMPARISON OF STUDENT PERFORMANCE ON THE FINAL YEAR OSCE FOR UNDERGRADUATE MEDICINE PROGRAM FACULTY OF MEDICINE, PUBLIC HEALTH AND NURSING UNIVERSITAS GADJAH MADA BEFORE AND DURING THE PANDEMIC

NATALIE AUDREY S, dr. Ide Pustaka Setiawan, M.Sc., Sp.OG; dr. Rachmadya Nur Hidayah, M.Sc, Ph.D

2022 | Skripsi | S1 KEDOKTERAN

Latar belakang: Sejak pandemi COVID-19 pada Maret 2020, pendekatan, metode, dan mekanisme proses pembelajaran harus disesuaikan dari pembelajaran tatap muka menjadi pembelajaran online, termasuk pelatihan keterampilan klinik di Program Sarjana Kedokteran, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada (FK-KMK UGM). Objective Structured Clinical Examination (OSCE) tingkat akhir adalah metode untuk menilai kompetensi keterampilan klinik mahasiswa kedokteran di FK-KMK UGM sebelum memasuki rotasi klinik. Pada Januari 2021, OSCE tingkat akhir dilakukan dengan menggunakan metode bauran; peserta ujian melaksanakan OSCE di tempat ujian dan penguji mengawasi melalui aplikasi video konferensi. Melihat adanya perubahan signifikan dalam proses pembelajaran dan penilaian keterampilan klinik, studi lebih lanjut diperlukan untuk mengevaluasi hasil OSCE sebelum dan saat pandemi. Tujuan: Untuk mengevaluasi performa mahasiswa pada OSCE tingkat akhir sebelum pandemi (2020) dan saat pandemi (2021). Metode: Penelitian ini bersifat deskriptif analitik dengan menggunakan data sekunder dari hasil OSCE tingkat akhir pada tahun 2020 dan 2021 di Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan Universitas Gadjah Mada. Subjek penelitian ini adalah seluruh mahasiswa kedokteran yang mengikuti OSCE tingkat akhir pada tahun 2020 dan 2021. Data akan dianalisis secara deskriptif untuk membandingkan performa mahasiswa pada OSCE tingkat akhir antara tahun 2020 dan 2021. Hasil: Total data yang dalam penelitian ini adalah 452 subjek, terdiri dari 248 hasil OSCE tingkat akhir di tahun 2020 (sebelum pandemi) dan 204 hasil OSCE tingkat akhir di tahun 2021 (saat pandemi). Hasil keseluruhan OSCE tingkat akhir pada tahun 2020 menunjukkan tingkat kelulusan 41,7% sedangkan pada tahun 2021 dengan tingkat kelulusan 43,6%. Nilai batas lulus kasus IPM Darurat Dewasa saat pandemi adalah yang terendah di antara kasus-kasus lain, dan nilai batas lulus untuk kasus IPM Anak Darurat adalah terendah keempat. Bahkan dengan nilai batas lulus rendah, stase IPM Darurat memiliki tingkat kelulusan terendah (66,67%). Keterampilan mahasiswa pada kasus resusitasi neonatus dan pemasangan implan di OSCE tingkat akhir saat pandemi lebih baik daripada sebelum pandemi. Kasus BLS dan Kateter memiliki peningkatan rata-rata global rating score tertinggi dan peningkatan signifikan dalam rata-rata skor rubrik. Peningkatan perfroma mahasiswa di masa pandemi juga terlihat pada kasus IPM Dewasa, THT, dan Neurologi. Rata-rata global rating score untuk kasus IPM Darurat Anak secara konsisten rendah di OSCE tingkat akhir sebelum dan saat pandemi. Sebaliknya, rata-rata global rating score untuk kasus Pap Smear secara konsisten baik di OSCE tingkat akhir sebelum dan saat pandemi. Terjadi penurunan performa mahasiswa pada kasus IPM Anak, Bedah Minor, dan pemasangan IUD saat pandemi. Kesimpulan: Perubahan pada proses pembelajaran dan penilaian keterampilan klinik berperan dalam performa mahasiswa sebelum dan selama pandemi, tetapi faktor lain termasuk pelatihan khusus persiapan OSCE tingkat akhir, OSCE tahunan, kurikulum, pembelajaran mandiri mahasiswa, dan masalah teknis juga harus dipertimbangkan.

Background: Since the COVID-19 pandemic started in March 2020, the approaches, methods, and mechanisms of learning process must be adjusted from a face-to face to online learning, including clinical skills training in Undergraduate Medicine Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (FM-PHN UGM). The final year Objective Structured Clinical Examination (OSCE) is the chosen method to assess clinical skills competence of medical students in FM-PHN UGM before entering clinical rotation. In January 2021, the final year OSCE was conducted using blended approach; students performed the OSCE in situ and examiners observed the performance via videoconferencing program. Considering significant changes in clinical skills learning and assessment approaches, there is a need to evaluate the OSCE results before and during the pandemic. Aim: To evaluate the results of student performance in the final year OSCE before the pandemic (2020) and during pandemic (2021). Method: This is a descriptive-analytic study using secondary data from the records of final year OSCE in 2020 and 2021 at FM-PHN UGM. Subjects are all students of both international and regular program who took the final year OSCE in the year 2020 and 2021. Data will be analysed descriptively to compare the student performance on the final year OSCE between the year 2020 and 2021. Result: The total data included in this research is 452 subjects, consisting of 248 results the final year OSCE in 2020 (before the pandemic) and 204 results of the final year OSCE in 2021 (during the pandemic). The overall result of final year OSCE in 2020 showed a 41.7% passing rate while the final year OSCE in 2021 showed a 43.6% passing rate. The cut-off score for IPM Emergency Adult in the during the pandemic was the lowest among other cases, and the cut-off score for IPM Emergency Children was the fourth lowest. Even with the low cut-off score, IPM Emergency station has the lowest passing rate (66.67%). The students' neonatal resuscitation and implant insertion skills at the final year OSCE during the pandemic is better than the students before the pandemic. BLS and Catheter case has the highest average global rating score increase and significant increase in the average rubric score. Increased students' performance during the pandemic can also be seen in IPM Adult, ENT, and Neurology cases. The average global rating score for IPM Emergency Children case is consistently low in both final year OSCE before and during the pandemic. In contrary, the average global rating score for Pap Smear case is consistently good in both final year OSCE before and during the pandemic. There is a decreased students' performance in the IPM Children, Minor Surgery, and IUD insertion cases during the pandemic. Conclusion: The clinical skills learning and assessment transformation play a role in the different students' performance before and during the pandemic, but other factors including the scheduled final year OSCE training preparation, yearly OSCEs, curriculum, students' individual learning activity, and technical issues should also be taken into consideration.

Kata Kunci : COVID-19 Pandemic, Performance, Competence, OSCE, Final Year, Medical Students, Clinical Skills, Online Learning