Psych CASC / OSCE · Foundations — research methods and study design
Journal club design critique — CASC/teaching station
MRCPsych/FRANZCP-style teaching/communication station: identify true design, map bias, contrast with proper RCT, name STROBE vs CONSORT, collaborative teaching tone.
On this page & tools
Target exams
Station brief
Format. Teaching/communication station, approximately 8–10 minutes. Facilitate, do not monologue. [1]
Candidate instructions. Help the team correctly name the design, list major bias threats, sketch what a true RCT would require, and choose STROBE vs CONSORT. Keep language accessible. Close with a practice-relevant bottom line about not changing suicide-prevention prescribing from this abstract alone. [2][3][4]
Candidate scenario
Methods summary (station material): non-random clinician assignment to Drug Z versus usual care; single tertiary clinic; 12-month suicide attempt outcome; completer analysis; abstract mislabels the study as randomised. [1]
Marking domains
- Correctly identifies design as observational cohort / non-randomised comparative, not RCT [1]
- Names confounding by indication, selection into a tertiary clinic, attrition/completer bias, and mislabelling risk [4][5]
- Outlines true RCT elements: random sequence, allocation concealment, blinding where feasible, ITT, pre-specified outcome [2][5][6]
- Assigns STROBE to the study as reported; CONSORT only if redesigned as a true RCT [2][3]
- Collaborative teaching tone; invites questions; avoids jargon pile-on
- Bottom line: do not change practice from this abstract alone; seek better designs and absolute risks
- Time management
Reveal assessor key
Open. "Let's not argue about the drug name yet — first, what design is this actually?" Board: assignment method = clinician choice → not randomised. [1]
Threats. Confounding by indication (who gets Drug Z?), single-clinic generalisability, completer analysis loses people who may have attempted suicide or stopped the drug, and the abstract's "randomised" label is a red flag for spin. [4][5]
Redesign sketch. Eligible bipolar adults → concealed random allocation → Drug Z vs usual care or active comparator → blinded outcome adjudication of attempts → analyse all randomised (ITT) → CONSORT flow. [2][5][6]
Reporting. As written: STROBE observational reporting. If redesigned as RCT: CONSORT. [2][3]
Close. "Interesting signal to generate hypotheses — not enough to rewrite suicide-prevention protocols. Next week we can pull a proper RCT or high-quality cohort." Thank the team. [1][4]
References
- [1]Grimes DA, Schulz KF An overview of clinical research: the lay of the land Lancet, 2002.PMID 11809203
- [2]Schulz KF, Altman DG, Moher D; CONSORT Group CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials BMJ, 2010.PMID 20332509
- [3]von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies Lancet, 2007.PMID 18064739
- [4]Grimes DA, Schulz KF Bias and causal associations in observational research Lancet, 2002.PMID 11812579
- [5]Hollis S, Campbell F What is meant by intention to treat analysis? Survey of published randomised controlled trials BMJ, 1999.PMID 10480822
- [6]Schulz KF, Chalmers I, Hayes RJ, Altman DG Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials JAMA, 1995.PMID 7823387