Email updates

Keep up to date with the latest news and content from BMC Medical Education and BioMed Central.

Open Access Research article

Modification of an OSCE format to enhance patient continuity in a high-stakes assessment of clinical performance

Rose Hatala1*, Sharon Marr2, Cary Cuncic1 and C Maria Bacchus3

Author Affiliations

1 Department of Medicine, University of British Columbia, Vancouver, BC, Canada

2 Department of Medicine, McMaster University, Hamilton, ON, Canada

3 Department of Medicine, University of Calgary, Calgary, AB, Canada

For all author emails, please log on.

BMC Medical Education 2011, 11:23  doi:10.1186/1472-6920-11-23

Published: 24 May 2011

Abstract

Background

Traditional Objective Structured Clinical Examinations (OSCEs) are psychometrically sound but have the limitation of fragmenting complex clinical cases into brief stations. We describe a pilot study of a modified OSCE that attempts to balance a typical OSCE format with a semblance of a continuous, complex, patient case.

Methods

Two OSCE scenarios were developed. Each scenario involved a single standardized patient and was subdivided into three sequential 10 minute sections that assessed separate content areas and competencies. Twenty Canadian PGY-4 internal medicine trainees were assessed by trained examiner pairs during each OSCE scenario. Paired examiners rated participant performance independent of each other, on each section of each scenario using a validated global rating scale. Inter-rater reliabilities and Pearson correlations between ratings of the 3 sections of each scenario were calculated. A generalizability study was conducted. Participant and examiner satisfaction was surveyed.

Results

There was no main effect of section or scenario. Inter-rater reliability was acceptable. The g-coefficient was 0.68; four scenarios would achieve 0.80. Moderate correlations between sections of a scenario suggest a possible halo effect. The majority of examiners and participants felt that the modified OSCE provided a sense of patient continuity.

Conclusions

The modified OSCE provides another approach to the assessment of clinical performance. It attempts to balance the advantages of a traditional OSCE with a sense of patient continuity.