Challenges and solutions in developing an objective and structured clinical examination for complementary and integrative medicine: A mixed-method approach.

This study explores the challenges encountered by developers when creating objective and structured clinical examination (OSCE) modules specifically for Korean medicine (KM). The complexity of developing pattern identification (PI) items, due to the lack of standardized materials and ambiguity in KM, was a primary focus. A mixed-method approach was utilized, including a survey, importance-performance analysis, and focus group interviews. Seven developers participated, creating a total of 21 OSCE modules. The main difficulties identified were in developing PI items, selecting appropriate cases, crafting realistic examination situations, determining scoring criteria, setting up checklists, and writing scenarios. Challenges were categorized into "case," "examination situation," "postexamination notes," "checklist," "scenario," "format," and "PI." The importance-performance analysis revealed improvements in module development capabilities with each iteration. For the future development of efficient OSCE modules, standardization of KM diagnostic methods and PI is essential. The study highlights the need for social and academic efforts, as well as support from the KM education community and schools, to address these challenges and enhance the development process.