McMaster University

McMaster University

Administering a TOSCE Session — Observation and Assessment

What does the observer do?

The observer is the person who is watching the team and evaluating individual and team competencies. The observer (or observers) also organizes the TOSCE session(s). Included in each McMaster-Ottawa TOSCE station package is a page that outlines what is required from the observer(s) for that particular station. Tasks typically include:

  1. distributing the station materials to the team;
  2. reading aloud the team instructions;
  3. when applicable, playing the station DVD;
  4. reading aloud the station summary (optional — team members may choose to read this silently themselves);
  5. keeping time (team members may ask for a warning at the 5 minutes remaining mark);
  6. assessing team collaboration (using the observer checklist); and
  7. at the completion of the station, debrief the team and offer feedback (using debriefing guide).

Who should participate as an observer?

Ideally, you want to have people who are committed to do this and are trained to be observers. Observers could be someone from your practice. Another option is to have a colleague from another practice who comes in, is trained and understands their role. If you decide to use someone from another practice just ensure he/she has enough experience in team based clinical work.

You can have 1 or 2 observers per station. During our recent evaluation of the 10 TOSCEs we assigned 2 observers per station and found high inter-rater reliability between observers (i.e. observers were consistent in their scoring) which suggests that only 1 observer may be needed to accurately assess the scenario.

What exactly is the observer assessing?

The observer’s job is to look at the six main competencies on the observer’s score sheet. These are competencies around which we have national consensus developed by a working group with members from across Canada. The checklist headings on the observer’s score sheet are the same domains that were part of this national framework: communication, collaboration, roles and responsibilities, collaborative patient centred approach, conflict management resolution, and team functioning.

The idea for the observer and checklist are not employed to assess a team member or a team’s clinical acumen around the topic (for example how well they manage diabetes). Rather, they are used to assess how well the team came together around a clinical problem and how well they worked together as a team. As such, the observers should focus on the six collaborative practice competency domains. Click here to download a printable version of the checklist.

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