A Comparison of Undergraduate Medical Student Performance on the Third Year OSCE in the Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada Before and During the Pandemic

AMARISSA A. TSABITA, dr. Rachmadya Nur Hidayah, M.Sc., Ph.D; dr. Ide Pustaka Setiawan, M.Sc, Sp. OG

2023 | Skripsi | S1 KEDOKTERAN

Latar Belakang: Pandemi COVID-19 mempengaruhi proses belajar mengajar. Institusi pendidikan kedokteran mengubah pendekatan mereka dari pembelajaran tatap muka menjadi pembelajaran daring, termasuk pelatihan dan penilaian keterampilan klinis di Program Kedokteran, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada (FK-KMK UGM). OSCE tahun ketiga menilai keterampilan klinis mahasiswa kedokteran, termasuk manajemen pasien, keterampilan prosedural, dan penalaran klinis. Selama pandemi, OSCE tahun ketiga yang diselenggarakan pada bulan Agustus 2021 menggunakan pendekatan yang berbeda dimana mahasiswa melaksanakan OSCE di Skills Laboratory, sementara penguji mengamati melalui aplikasi video konferensi. Perubahan ini dapat menyebabkan perbedaan yang signifikan dalam performa mahasiswa. Oleh karena itu, penting untuk mengevaluasi hasil OSCE tahun ketiga sebelum dan selama pandemi untuk mengatasi tantangan dan meningkatkan kualitas pembelajaran keterampilan klinis di FK-KMK UGM. Tujuan: Untuk mengevaluasi performa mahasiswa pada OSCE tahun ketiga sebelum pandemi (2019) dan selama pandemi (2021). Metode: Penelitian ini menggunakan desain studi deskriptif-analitik. Data dikumpulkan dari data sekunder nilai OSCE mahasiswa tahun ketiga di Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada. Subjek penelitian adalah seluruh mahasiswa dari program internasional dan reguler yang mengikuti OSCE tahun ketiga pada tahun 2019 dan 2021. Data dianalisis secara deskriptif untuk membandingkan performa mahasiswa pada OSCE tahun ketiga antara tahun 2019 dan 2021. Hasil: Penelitian ini melibatkan 455 subjek, yang terdiri dari 242 hasil OSCE tahun ketiga pada tahun 2019 (sebelum pandemi) dan 213 hasil OSCE tahun ketiga pada tahun 2021 (selama pandemi). Hasil keseluruhan OSCE tahun ketiga pada tahun 2019 menunjukkan tingkat kelulusan 45,87%, sedangkan OSCE tahun ketiga pada tahun 2021 menunjukkan tingkat kelulusan 50,23%. Nilai batas lulus untuk Bedah Minor menurun secara signifikan selama pandemi. Bedah minor adalah satu-satunya kasus yang mengalami penurunan nilai batas lulus; nilai batas lulus kasus lainnya meningkat selama pandemi. Peningkatan rata-rata global rating score, rata-rata nilai rubrik, nilai batas lulus, dan tingkat kelulusan selama pandemi dapat dilihat pada Baby Delivery, Pemasangan IUD, Inspeksi Visual Asam Asetat, IPM Dewasa, Pemeriksaan Kulit dan Kelamin, Pemeriksaan THT, Pemeriksaan Mata, dan prosedur IV Line. Di sisi lain, terjadi penurunan nilai rata-rata rubrik, rata-rata global rating score, dan tingkat kelulusan untuk prosedur Pap Smear dan pemeriksaan Psikiatri selama pandemi. Tidak ada perbedaan yang signifikan antara performa mahasiswa untuk pemasangan Implan pada OSCE tahun ketiga sebelum dan selama pandemi. Penelitian ini juga menemukan bahwa Neurologi memiliki nilai batas lulus tertinggi pada OSCE tahun ketiga sebelum dan selama pandemi. Kesimpulan: Banyak faktor yang dapat menyebabkan peningkatan atau penurunan performa mahasiswa dalam OSCE tahun ketiga. Transformasi pembelajaran online karena pandemi memainkan peran penting dalam perbedaan performa mahasiswa sebelum dan selama pandemi. Namun, faktor-faktor lain mulai dari yang paling signifikan seperti pelatihan terjadwal untuk OSCE tahun ketiga 2021, kurikulum pelatihan Skills Laboratory, dan kondisi psikologis serta strategi pembelajaran mahasiswa hingga yang kurang signifikan seperti masalah teknis selama OSCE tahun ketiga juga harus dipertimbangkan. Kata kunci: OSCE, tahun ketiga, mahasiswa kedokteran, COVID-19, keterampilan klinis, pembelajaran daring, performa

Background: COVID-19 pandemic disrupted the delivery of the teaching and learning process. Medical schools changed their approach from traditional face-to-face to online learning, including clinical skills training and assessment in the Undergraduate Medicine Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (FM-PHN UGM). The third year OSCE assesses medical students' clinical skills, including patient management, procedural skills, and clinical reasoning. During the pandemic, the third year OSCE held in August 2021 adopted a different approach by having the students perform on site at the Skills Laboratory, while the examiners observed the performance via video conferencing. These changes may cause significant differences in student performance. Therefore, it is important to evaluate the third year OSCE results before and during the pandemic to address the challenges and improve the quality of clinical skills learning in FM-PHN UGM. Aim: To evaluate student performance results in the third year OSCE before the pandemic (2019) and during the pandemic (2021). Method: This study used a descriptive-analytic study design. The data was collected from the secondary records of the third year OSCE students' scores at the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada. The subjects was all students from both international and regular programs who took the third year OSCE in the year 2019 and 2021. The data was analyzed descriptively to compare the student performance on the third year OSCE between 2019 and 2021. Result: This research included 455 subjects, comprising 242 results from the third year OSCE in 2019 (before the pandemic) and 213 results from the third year OSCE in 2021 (during the pandemic). The overall result of the third year OSCE in 2019 showed a 45.87% passing rate, while the third year OSCE in 2021 showed a 50.23% passing rate. The cut-off score for Minor Surgery decreased significantly during the pandemic. It is the only case with a decrease in the cut-off score; the rest of the cases� cut-off scores increased during the pandemic. Improved average global rating score, average rubric score, cut-off score, and passing rate during the pandemic can be seen in Baby Delivery, Intrauterine Device Insertion, Visual Acetic Acid Inspection, Integrated Patient Management for Adults, Dermatology and Venereology examination, ENT examination, Eyes examination, and IV Line procedure. On the other hand, there has been a decrease in the average rubric score, average global rating score, and passing rate for Pap Smear procedure and Psychiatry examination during the pandemic. There is no significant difference between the students� performance for Implant insertion skills in the third year OSCE before and during the pandemic. This research also found that Neurology has the highest cut-off score in the third year OSCE before and during the pandemic. Conclusion: Numerous factors may have caused the improvement or decline in students' performance in the third year OSCE. The online learning transformation due to the pandemic played a significant role in the different students' performance before and during the pandemic. However, other factors starting from the most significant to the less significant such as the scheduled training for the 2021 third year OSCE, skills laboratory training curriculum, students' psychological well-being and learning strategies, and technical issues during the third year OSCE should also be considered. Keywords: OSCE, third year, medical students, COVID-19, clinical skills, online learning, performance

Kata Kunci : OSCE, third year, medical students, COVID-19, clinical skills, online learning, performance