Assessment of interprofessional learning: the design of an interprofessional objective structured clinical examination (iOSCE) approach

WilsonCentre for Research in Education, University of Toronto, CanadaINTRODUCTIONThere is a growing imperative for interprofessional educa-tion (IPE) and a shift towards interprofessional practicelinked to government initiatives to modernize healthcareservices and improve patient/client care (e.g. Barr et al.,2005). IPE is meant to instill the knowledge, skills, attitudesand values necessary for interdependent collaboration andteamwork with a focus on the efﬁcient delivery of high-quality patient/client-centred care. The link between IPEand equipping students in healthcare for collaborativepractice has been made for several years (e.g. Szasz, 1969). Despite the broad adoption of IPE across a number ofeducational institutions, in general, there continues to belittle focus on the development and implementation ofsound assessment strategies.Widely used in medicine, the objective structured clinicalexamination(OSCE)aimstoassessclinicalknowledge,skills,behaviours and attitudes by structured observation (van derVleuten & Schuwirth, 2005). An interprofessional OSCE(iOSCE) uses this method to assess collaborative knowledge,skills, behaviours and attitudes (Morison & Stewart, 2005). TheiOSCEprovidesanalternativetoreﬂectionexercisesthatare more typically used to assess interprofessional attributes.This article reports on the development of an iOSCE in alarge university in North America which contains 10 healthscience faculties: dentistry, physical education and health,medical radiation sciences, medicine, nursing, occupationaltherapy, physical therapy, pharmacy, social work andspeech–language pathology. Speciﬁcally, we describe themethods used to engage participation from all healthprofessions in its development; report on the topic themesselected to develop into clinical scenarios; and providedetails of the iterative process planned to yield a reliable andvalid product.METHODSInterprofessional leaders from these different faculties(n¼23) with collective responsibility for overseeingthe development and implementation of a new IPEcurriculum were invited to participate in this study.A modiﬁed Delphi process was used to generate contentfor the iOSCE. A Delphi is a decision-making process thatuses expert opinion, gathered anonymously in the form of asurvey, under the guidance and direction of a facilitator toreach group consensus through collaboration, independentanalysis and iteration. It allows for moderation/changethrough group processes (Rowe & Wright, 1999) andrequires several rounds to obtain consensus. As describedbelow, three rounds were used in this study.In general, all faculties at the university had familiaritywith and involvement in the IPE curriculum planning. Themajority had direct experience in developing IPE learningactivities (78%, n¼18), half had experience as examiners ordevelopers of a traditional OSCE station, but as this is a newmethod of assessment none had experience as an examineror developer of an iOSCE station.In the ﬁrst round, participants were asked to write ﬁvebrief healthcare clinical scenarios, requiring participation ofﬁve or more different healthcare professions that involvedcompletion of a task as an interprofessional team. Thisresulted in a pool of 80 scenarios. Scenarios werethematically analyzed by the project team and through aprocess of discussion and modiﬁcation, agreement was