Team Objective Structured Bedside Assessment (TOSBA) in Paediatric Undergraduate Students.

Abstract

Objective: To develop a team objective structured bedside assessment (TOSBA) tool for assessing the paediatric undergraduate students' clinical skills at the bedside.

Study design: A validation, cross-sectional study. Place and Duration of the Study: Department of Paediatrics, Ziauddin Medical University Hospital, Karachi, Pakistan, from March to June, 2023.

Methodology: Three groups of 4th-year students (n = 61) at Ziauddin Medical University underwent this formative assessment process 4-5 times during a 4-week rotation. Psychometric analysis for reliability was done by calculating the internal consistency and item-total correlation of TOSBA scores. At the same time, validity was determined by correlating TOSBA scores with the end-of-rotation objective structured clinical evaluation (OSCE) scores.

Results: The TOSBA tool's overall reliability was good, with Cronbach's alpha values >0.7 for all clinical skills assessed. Spearman's correlation revealed r2 >0.4 (p <0.001) for history taking and clinical reasoning. Item-total correlation varied across stations, occasionally falling below 0.7. Strong correlations (0.46 to 0.73, p <0.001) were observed between similar constructs. The multi-trait-multi-method matrix highlighted divergent validity, showing no or negative correlations within the same method (TOSBA or OSCE), except for physical examination, which differed from OSCE.

Conclusion: The TOSBA tool developed for formative assessment of undergraduate paediatric students is a reliable and moderately valid tool for formative assessment of undergraduate students.

Key words: Objective structured clinical evaluation, Reliability, Team objective structured bedside assessment, Undergraduate students, Validity.