The Objective Structured Clinical Examination R...
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Results: A greater number of stations and similarity between tasks at different stations increased the reliability of the OSCE. A greater number of stations increased sampling of material and content validity. Correlation between the OSCE and precertification examinations ranged between 0.59 and 0.71, with P< or =.01. Correlation between the OSCE and monthly clinical evaluations was much lower (0.39-0.57), but still statistically significant at P< or =.05. Gaps between expected and actual performance were documented. Overall, the experience of being a standardized patient was viewed as positive by children and their parents.
Conclusions: With appropriate attention to design, acceptable reliability and validity can be achieved for the OSCE. Significant correlations between the OSCE and precertification examinations as well as monthly clinical evaluations were found, the former being stronger than the latter. We conclude that the combination of the OSCE, standardized board examinations, and direct observation in the clinical setting has the potential to become the \"gold standard\" for measuring physician competence.
The purpose of this research was to assess reliability and construct validity of the objective structured clinical examination (OSCE) for evaluating the clinical skills of surgical residents. Reliability refers to precision of the examination and construct validity to the degree to which the examination can discriminate between different levels of training. Twenty-seven second postgraduate year surgical residents took a 38-station OSCE representing seven surgical specialties and that tested history-taking, physical examination, problem-solving, technical skills, and attitudes. A couplet methodology was used wherein a patient encounter was followed by written questions aimed at testing problem-solving and patient management capabilities. Thirty-six standardized patients were trained and 36 surgeons served as examiners marking from structured checklists. Overall reliability, Cronbach's alpha, was 0.89. Construct validity was examined by comparing the scores of the residents with those of a group of graduates of foreign medical schools applying for a \"pre-internship\" program. For 17 of 19 stations that both groups took, the residents performed significantly better (p less than 0.01). Individual station validity was significant for 32 of 38 stations (r = 0.36 to 0.82, p less than 0.05). The examinations took 3.83 hours at a cost of $5,293 (Canadian dollars). The OSCE has been shown to be a reliable method of assessing clinical skills of surgical residents, construct validity has been established, and inter-item validity confirmed. Reliabilities achieved exceed those traditionally required for both acceptance and promotion decisions.
An objective structured clinical examination (OSCE) is an approach to the assessment of clinical competence in which the components are assessed in a planned or structured way with attention being paid to the objectivity of the examination which is basically an organization framework consisting of multiple stations around which students rotate and at which students perform and are assessed on specific tasks. OSCE is a modern type of examination often used for assessment in health care disciplines.
The development of OSCE is credited to Prof. Ronald Harden. Since the publication of the first paper in the British Medical Journal in 1975, OSCE has been widely adopted in many medical schools and professional bodies. The format of OSCE is continuously evolving and may include real or simulated patients, clinical specimens, and other clinical materials. OSCE is primarily used to assess focused clinical skills such as history taking, physical examination, diagnosis, communication, and counseling.
Marking in OSCEs is done by the examiner. Occasionally written stations, for example, writing a prescription chart, are used and these are marked like written examinations, again usually using a standardized mark sheet. One of the ways an OSCE is made objective is by having a detailed mark scheme and standard set of questions. For example, a station concerning the demonstration to a simulated patient on how to use a metered dose inhaler [MDI] would award points for specific actions which are performed safely and accurately. The examiner can often vary the marks depending on how well the candidate performed the step. At the end of the mark sheet, the examiner often has a small number of marks that they can use to weight the station depending on performance and if a simulated patient is used, then they are often asked to add marks depending on the candidates approach. At the end, the examiner is often asked to give a \"global score\". This is usually used as a subjective score based on the candidates overall performance, not taking into account how many marks the candidate scored. The examiner is usually asked to rate the candidate as pass/borderline/fail or sometimes as excellent/good/pass/borderline/fail. This is then used to determine the individual pass mark for the station.
There are, however, criticisms that the OSCE stations can never be truly standardized and objective in the same way as a written exam. It has been known for different patients / actors to afford more assistance, and for different marking criteria to be applied. Finally, it is not uncommon at certain institutions for members of teaching staff be known to students (and vice versa) as the examiner. This familiarity does not necessarily affect the integrity of the examination process, although there is a deviation from anonymous marking. However, in OSCEs that use several circuits of the same stations the marking is repeatedly shown to be very consistent which supports the validity that the OSCE is a fair clinical examination. There are arguments for and against quarantining OSCE examinees to prevent sharing of exam information. Although the data tend to show no improvement in the overall scores in a later OSCE session, the research methodology is flawed and validity of the claim is questionable. A study suggested that marks do not give a sound inference of student collusion in an OSCE.
Preparing for OSCEs is very different from preparing for an examination on theory. In an OSCE, clinical skills are tested rather than pure theoretical knowledge. It is essential to learn correct clinical methods, and then practice repeatedly until one perfects the methods whilst simultaneously developing an understanding of the underlying theory behind the methods used. Marks are awarded for each step in the method; hence, it is essential to dissect the method into its individual steps, learn the steps, and then learn to perform the steps in a sequence.
Objective. To record the perceptions of the final year MBBS students of Khyber Medical College (KMC) Peshawar regarding Objective Structured Clinical Examination (OSCE) conducted in the year 2016. Materials and Methods. This study was conducted in April 2016 which is in fact a reaudit of our similar survey done back in 2015. A total of 250 final year MBBS students participated by filling in a validated and pretested questionnaire already used by Russel et al. and Khan et al. in similar but separate studies including questions regarding exam content, quality of performance, OSCE validity and reliability, and so forth. The data was analyzed using SPSS version 20. Results. The study group comprised 160 (64%) males and 90 (36%) females. 220 (88%) stated that exam was fair and comprehensive; 94% believed OSCE was more stressful and mentally tougher. 96% of the students considered OSCE as valid and reliable and 87% were happy with its use in clinical competence assessment. Conclusion. Majority of students declared their final year OSCE as fair, comprehensive, standardized, less biased, and reliable format of examination but believed it was more stressful and mentally tougher than traditional examination methods.
Objective structured clinical examination (OSCE) was introduced by Harden and colleagues in 1975. Since its origin in the 70s, objective structured clinical examination (OSCE) has received worldwide acceptance and appreciation as a fair and standardized format to assess the clinical competences of medical students and residents .
Medical educationists have long been trying to devise a valid and reliable assessment method in medicine and surgery. After a long story of efforts, OSCE became the cornerstone of medical assessment throughout the world. The objective structured clinical examination (OSCE) is an approach for student assessment in which different aspects of clinical competence are evaluated in a comprehensive, consistent, and structured manner with close attention to the objectivity of the process [2, 3]. In order to refine this system of clinical exam, it is vital to understand how do students taking OSCE feel and think about it.
The history of medical education in Pakistan reveals that long and short cases, essay writing, multiple choice questions (MCQs), instruments and specimen based oral interviews, and so forth have been the most popular forms of clinical competence assessment for decades with questionable validity and reliability. The body awarding the postgraduate medical degrees in Pakistan, the College of Physicians and Surgeons of Pakistan (CPSP), initiated OSCE as a method of clinical assessment in the 1990s which was later adopted by the Pakistan Medical and Dental Council (PMDC) at the undergraduate level as well. Khyber Medical University took a step forward by substituting traditional viva examination with OSCE in 2010 in the province of Khyber Pakhtunkhwa (KPK), Pakistan. As per this initiative, all medical and dental schools in KPK embraced OSCE as a part of final exam for assessing clinical competencies of students .
This cross-sectional observational study included 250 final year MBBS students of Khyber Medical College (KMC) Peshawar who took part in the annual clinical evaluation in the subject of General Medicine conducted by Khyber Medical University (KMU) in the department of medicine of the Khyber Teaching Hospital (KTH) Peshawar in April 2016. The study was approved by the Ethics Committee of KMC/KTH and an informed written consent was obtained from every participant. Data was collected on a structured questionnaire used by Russel et al. and Khan et al. in similar but separate studies in the past. The questionnaire had closed-ended questions related to the OSCE evaluation like syllabus, fairness, stress factor, impact of gender, ethnicity and personality on the individual and overall results, OSCE administration, quality of performance testing, validity and reliability, and students rating of different assessment formats and recommendation for the future use. The last section of the questionnaire invited open comments from the candidates about OSCE. The questionnaire was pilot-tested by a group of ten house officers who had recently passed their exam from KMC, not only to check the quality and content of the questionnaire but also to rectify any errors therein in the light of their suggestions. 59ce067264