EXPERIENCE OF THE OBJECTIVE STRUCTURED CLINICAL EXAMINATION AS A PART OF STATE CERTIFICATION OF GRADUATES OF THE CLINICAL RESIDENCY ON THE SPECIALTY OF ANESTHESIOLOGY AND REANIMATOLOGY: THE STATION OF SUBARACHNOID SPACE PUNCTURE

The practical part of the state final certification implies an assessment of skills.

The objective of our study was the approbation of the Station of Subarachnoid Space Puncture as a part of the objective structured clinical examination.

Subjects and methods. 26 students of the second year of the clinical residency were included in the study; they all were taking the practical part of the final exam in Anesthesiology and Reanimatology. A phantom-simulator was used for the manipulation, which allowed authentic simulating of a lumbar puncture. Two trainers evaluated the manual skills, independently of each other.

Results. 25 (96%) residents passed the station successfully. The total time required to pass the station made 3.1 (2.58, 3.45) min. In 1 (4%) case, the student failed to gain the required number of points for the successful passage of this station. The most common mistakes during the manipulation were associated with improper control of the patient's state after the drug administration into subarachnoid space, there were 14 (54%) such cases; and in 10 (38%) cases, several attempts were required to obtain cerebrospinal fluid. The monitoring of the check-list filling incompletion demonstrated that different trainers at the station could use it. The difference in the filled check-lists was less than 5%.

Conclusions. The developed check-list allows performing an objective assessment of the practical skills of graduates from the clinical residency. 

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