Objective structured clinical examination (OSCE)
From SCOME Wiki
In its "Toolbox of assessment methods the Accreditation Council for Graduate Medical Education (ACGME) defines Objective structured clinical examination (OSCE) as follows.
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Description
In an objective structured clinical examination (OSCE) one or more assessment tools are administered at 12 to 20 separate standardized patient encounter stations, each station lasting 10-15 minutes. Between stations candidates may complete patient notes or a brief written examination about the previous patient encounter. All candidates move from station to station in sequence on the same schedule. Standardized patients are the primary assessment tool used in OSCEs, but OSCEs have included other assessment tools such as data interpretation exercises using clinical cases, and clinical scenarios with mannequins, to assess technical skills.
Use
OSCEs have been administered in most US medical schools, many residency programs, and by the licensure boards in Canada for more than five years. The OSCE format provides a standardized means to assess: physical examination and history taking skills; communication skills with patients and family members, breadth and depth of knowledge; ability to summarize and document findings; ability to make a differential diagnosis, or plan treatment; and clinical judgment based upon patient notes.
Psychometric qualities
OSCEs can provide means to obtain direct measures in a standardized manner of a patient-doctor encounter. OSCEs are not useful to measure skills or abilities in continuity of care with repeated patient encounters or invasive procedures. Because OSCEs often use standardized patients the same advantages and limitations apply (See toolbox description of standardized patient examination). A separate performance score is derived for each task performed at a station and scores are combined across stations or tasks to determine a pass/fail score. Statistical weighting of scores on individual tasks is controversial and not recommended. An OSCE with 14 to 18 stations is recommended to obtain reliable measurements of performance.
Feasibility/Practicality
OSCEs are very useful to measure specific clinical skills and abilities, but are difficult to create and administer. OSCEs are only cost-effective when many candidates are to be examined at one administration. Most OSCEs are administered in medical center outpatient facilities or specially designed patient examining rooms with closed circuit television. A separate room or cubical is needed for each station. For most residency programs developing and administering an OSCE will require the resources and expertise of a consortium of residency programs in an academic institution or metropolitan area.
Suggested reference
- Norman, Geoffrey. Evaluation Methods: A resource handbook. Hamilton, Ontario, Canada: Program for Educational Development, McMaster University, 1995: 71-77.
