The Objective Structured Clinical Examination. The New Gold Standard for Evaluating Postgraduate Clinical Performance

Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, USA.
Annals of Surgery (Impact Factor: 8.33). 01/1996; 222(6):735-42. DOI: 10.1097/00000658-199512000-00007
Source: PubMed


The authors determine the reliability, validity, and usefulness of the Objective Structured Clinical Examination (OSCE) in the evaluation of surgical residents.
Interest is increasing in using the OSCE as a measurement of clinical competence and as a certification tool. However, concerns exist about the reliability, feasibility, and cost of the OSCE. Experience with the OSCE in postgraduate training programs is limited.
A comprehensive 38-station OSCE was administered to 56 surgical residents. Residents were grouped into three levels of training; interns, junior residents, and senior residents. The reliability of the examination was assessed by coefficient alpha; its validity, by the construct of experience. Differences between training levels and in performance on the various OSCE problems were determined by a three-way analysis of variance with two repeated measures and the Student-Newman-Keuls post hoc test. Pearson correlations were used to determine the relationship between OSCE and American Board of Surgery In-Training Examination (ABSITE) scores.
The reliability of the OSCE was very high (0.91). Performance varied significantly according to level of training (postgraduate year; p < 0.0001). Senior residents performed best, and interns performed worst. The OSCE problems differed significantly in difficulty (p , 0.0001). Overall scores were poor. Important and specific performance deficits were identified at all levels of training. The ABSITE clinical scores, unlike the basic science scores, correlated modestly with the OSCE scores when level of training was held constant.
The OSCE is a highly reliable and valid clinical examination that provides unique information about the performance of individual residents and the quality of postgraduate training programs.

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Available from: William E. Strodel, Jun 13, 2014
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    • "Objective structured clinical examination (OSCE) has become a mainstay of assessment in medical and healthcare education reflecting a competency-based paradigm[1]. A useful tool, OSCE has been described as the 'gold standard' for assessment of clinical competence[2,3]. Many of the benefits of OSCEs are related to their feasibility, flexibility and adaptability. "
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    ABSTRACT: Objective Structured Clinical Examination (OSCE) is a core component of undergraduate medical student assessment. With increased emphasis on integrated programmes, more courses include OSCEs in the traditionally ‘preclinical’ years. The acceptability and impact of such assessment methods at this stage of training is unknown. In 2013 and 2014 University College London Medical School piloted a formative, integrated OSCE in years 1 and 2 of the undergraduate medical degree programme. This study with a sequential exploratory design aimed to explore the acceptability and impact of such an OSCE in the early years of medical school. 1280 students completed the OSCE and were invited to complete a questionnaire exploring their views of the OSCE (response rate 96.6 %). Four focus groups, each with five or six participants (22 in total) were subsequently held to further explore themes. Data was independently transcribed and coded using thematic analysis. Students were strongly in favour of the introduction of an OSCE in addition to existing assessments. Six overarching themes were identified: application of knowledge and skills; OSCE as an experience; OSCE as a process; a learning curve; becoming a doctor; and creating an effective OSCE. Results strongly support the role of OSCE early in the medical course with many benefits reported. An OSCE at this stage aligns with the vision of integrated medical education which includes early patient contact and introduction of clinical and professional skills. It also fosters feelings of responsibility and professional identity amongst students.
    Full-text · Article · Jan 2016 · BMC Medical Education
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    • "(Barman, 2005; Caraccio, 2000; Merrick, 2000; Auewarakul, 2005). Its reliability is determined mainly by the number of stations, with more stations increasing the reliability (Barman, 2005; Sloan 1995; Joorabchi, 1991). "

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