OSCE - praktische Tipps zur Implementierung einer klinisch-praktischen Prüfung OSCE - hands on instructions for the implementation of an objective structured clinical examination

Introduction:Objective structured clinical examinations (OSCEs) have proved to be a reliable and valid assessment tool for basic clinical skills. In regards to the more and more practical education of medical students there is an increasing need for the implementation of OSCEs. To facilitate this implementation we would like to give a review of literature and to present our 12 station OSCE at the Medical Hospital of the University of Heidelberg. Methods: During winter term 2004 / 2005 143 medical students in thir 3rd year of training participated the OSCE. For the conception of the assessment a blueprint was used. Standard setting was carried out with a modified Angoff method, students performance was assessed by experts using self-developed checklists. Results: The OSCE at the Medical Hospital of the University of Heidelberg showed a reliability of 0,748. According to the results of the standard setting procedure 142 students (99,3%) passed the exam. Taking the OSCE on the first, second or third day of assessment did not have impact on students' performance. Discussion: The OSCE at the Medical Hospital of the University of Heidelberg proves to be a reliable and fair assessment tool. Even the OSCE represents an assessment tool that needs resources and time it is well accepted in students and raters if it is planned and organised carefully.

[1]  A H Townsend,et al.  The use of an objective structured clinical examination (OSCE) for formative and summative assessment in a general practice clinical attachment and its relationship to final medical school examination performance , 2001, Medical education.

[2]  Miriam Friedman Ben-David,et al.  AMEE Guide No. 18: Standard setting in student assessment , 2000 .

[3]  G. Regehr,et al.  Assessing the generalizability of OSCE measures across content domains. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[4]  S. Zipfel,et al.  Kommunikations- und Interaktionstraining im psychosomatischen Praktikum: Einsatz von standardisierten Patienten , 2003 .

[5]  David Newble,et al.  Techniques for measuring clinical competence: objective structured clinical examinations , 2004, Medical education.

[6]  J. Shatzer,et al.  For Personal Use Only. Reproduce with Permission from the Lancet Publishing Group. Standard Setting Assessment of Clinical Competence Medical Education Quartet , 2022 .

[7]  J. Colliver,et al.  Assessment of Empathy in a Standardized-Patient Examination , 1998 .

[8]  R. Reznick,et al.  Large‐scale high‐stakes testing with an OSCE: report from the Medical Council of Canada , 1996, Academic medicine : journal of the Association of American Medical Colleges.

[9]  G. Regehr,et al.  The Effect of Candidates' Perceptions of the Evaluation Method on Reliability of Checklist and Global Rating Scores in an Objective Structured Clinical Examination , 2002, Academic medicine : journal of the Association of American Medical Colleges.

[10]  R. L. Ebel,et al.  Essentials of educational measurement , 1972 .

[11]  Z. Miedzybrodzka,et al.  Factor analysis can be a useful standard setting tool in a high stakes OSCE assessment , 2004, Medical education.

[12]  M. Cantrell,et al.  Surveying Students' Attitudes During the OSCE , 1998, Advances in health sciences education : theory and practice.

[13]  M. Davis OSCE: the Dundee experience , 2003, Medical teacher.

[14]  R. Harden,et al.  Assessment of clinical competence using objective structured examination. , 1975, British medical journal.

[15]  G. Regehr,et al.  OSCE checklists do not capture increasing levels of expertise. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[16]  R. Reznick,et al.  The use of global ratings in OSCE station scores , 1996, Advances in health sciences education : theory and practice.

[17]  Geoffrey R. Norman,et al.  Performance-Based Assessment: Lessons From the Health Professions , 1995 .

[18]  David B. Swanson,et al.  Assessment of clinical skills with standardized patients: State of the art , 1990 .

[19]  Richard Reznick,et al.  Using the Judgments of Physician Examiners in Setting the Standards for a National Multi-center High Stakes OSCE , 1997, Advances in health sciences education : theory and practice.

[20]  K. Shaffer,et al.  Clinical competence assessment in radiology: introduction of an objective structured clinical examination in the medical school curriculum. , 2001, Academic radiology.

[21]  J. Boulet,et al.  The management of patient encounter time in a high‐stakes assessment using standardized patients , 2000, Medical education.

[22]  C. V. D. van der Vleuten,et al.  The assessment of professional competence: Developments, research and practical implications. , 1996, Advances in health sciences education : theory and practice.

[23]  H. Dreyfus Mind Over Machine , 1986 .

[24]  T. Wilkinson,et al.  Objectivity in Objective Structured Clinical Examinations: Checklists Are No Substitute for Examiner Commitment , 2003, Academic medicine : journal of the Association of American Medical Colleges.

[25]  H. Schmidt,et al.  A cognitive perspective on medical expertise: theory and implication [published erratum appears in Acad Med 1992 Apr;67(4):287] , 1990, Academic medicine : journal of the Association of American Medical Colleges.

[26]  R. Kutob,et al.  Correlations of family medicine clerkship evaluations and Objective Structured Clinical Examination scores and residency directors' ratings. , 1999, Family medicine.

[27]  T. Schilling,et al.  Integriertes Skills-Lab-Konzept für die studentische Ausbildung in der Inneren Medizin , 2005 .

[28]  R. Reznick,et al.  Process-rating forms versus task-specific checklists in an OSCE for medical licensure. Medical Council of Canada. , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[29]  G. Regehr,et al.  Validation of an objective structured clinical examination in psychiatry , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[30]  G. Miller The assessment of clinical skills/competence/performance , 1990, Academic medicine : journal of the Association of American Medical Colleges.

[31]  I. R. Hart,et al.  The effectiveness of immediate feedback during the Objective Structured Clinical Examination , 1989, Medical education.

[32]  B. Mavis,et al.  A Survey of Student Assessment in U.S. Medical Schools: The Balance of Breadth Versus Fidelity , 2001, Teaching and learning in medicine.

[33]  R. Reznick,et al.  Comparing the psychometric properties of checklists and global rating scales for assessing performance on an OSCE‐format examination , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[34]  V. Köllner,et al.  Integration eines Kommunikationstrainings in die klinische Lehre , 2003 .

[35]  Samuel A. Livingston,et al.  Passing Scores: A Manual for Setting Standards of Performance on Educational and Occupational Tests. , 1982 .

[36]  H. Barrows An overview of the uses of standardized patients for teaching and evaluating clinical skills. AAMC , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[37]  W. Herzog,et al.  Role-playing for more realistic technical skills training , 2005, Medical teacher.

[38]  G. Norman,et al.  Pitfalls in the pursuit of objectivity: issues of validity, efficiency and acceptability , 1991, Medical education.

[39]  M. Cusimano,et al.  Consistency of Standards and Stability of Pass/Fail Decisions with Examinee-Based Standard-Setting Methods in a Small-Scale Objective Structured Clinical Examination , 2004, Academic medicine : journal of the Association of American Medical Colleges.

[40]  S. Whiten,et al.  Marks, scores and grades: scaling and aggregating student assessment outcomes , 2000, Medical education.

[41]  John R Boulet,et al.  Setting defensible performance standards on OSCEs and standardized patient examinations , 2003, Medical teacher.

[42]  G. Norman,et al.  Pitfalls in the pursuit of objectivity: issues of reliability , 1991, Medical education.

[43]  L. Nedelsky Absolute Grading Standards for Objective Tests , 1954 .

[44]  S. Fletcher,et al.  The relationship between second-year medical students' OSCE scores and USMLE Step 1 scores , 2002, Medical teacher.

[45]  J. Searle,et al.  Defining competency – the role of standard setting , 2000, Medical education.

[46]  Steven R Simon,et al.  How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE) , 2002, BMC medical education.

[47]  H. Merrick,et al.  Objective Structured Clinical Examination Technical Skill Stations Correlate More Closely with Postgraduate Year Level than Do Clinical Skill Stations , 2001, The American surgeon.

[48]  Brian Hodges,et al.  Analytic global OSCE ratings are sensitive to level of training , 2003, Medical education.