Challenges and solutions in developing an objective and structured clinical examination for complementary and integrative medicine: a qualitative study

Abstract

Abstract Background The growing prevalence of chronic diseases emphasizes the importance of multidisciplinary and integrative medical care, which considers various factors in the diagnosis and treatment processes. Therefore, training and evaluation on information gathering, physical examination, and patient education for ideal integrative medical care are necessary. An objective and structured clinical examination (OSCE) is widely used in medical education as a tool for evaluating overall clinical performance. This study developed OSCE modules for ideal complementary and integrative medical care practice in Korea. We report the problems and solutions that occurred during this process, as well as future tasks. Methods A total of 21 OSCE modules were developed according to 3 different diseases for each of the 7 clinical presentations (CP). Seven clinical experts developed the OSCE modules in each specialized field. Quality control was conducted through repeated feedback from two medical education experts and a standardized patient educator (SP educator). Analysis of the contents of each feedback, a survey of the 7 clinical experts, weekly meetings, and a focus group interview (FGI) was conducted to derive the challenges and possible solutions. Self-evaluation of OSCE development competency and importance-performance analysis (IPA) were conducted for the 7 experts after the main development process. Results Seven main themes and 18 subcategories were extracted. The main challenges of developers were categorized into “case,” “test situation,” “post-encounter note,” “checklist,” “scenario,” “format,” and “pattern identification.” During module development, they solved these challenges through discussions among developers and medical education experts. All solutions were categorized into 33 codes. Our survey found their competency in all items to be better than before development, and that they considered pattern identification (PI) the greatest challenge due to its ambiguity. Conclusion We found that the more OSCE modules the developers worked on, the more their competency was improved. However, they faced many challenges when developing the modules, which they resolved through discussions on the project. For further effective OSCE module development, we note that social and college-level support should be provided in the form of standardized schemas and human and spatial resources.