How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE)

Claus Hamann¹ , Kevin Volkan² , Mary B Fishman³ , Ronald C Silvestri⁴ , Steven R Simon⁵ and Suzanne W Fletcher⁵

¹Geriatric Medicine Unit, Massachusetts General Hospital, 100 Charles River Plaza, Fifth Floor, Boston MA, USA

²Program in Psychology, California State University Channel Islands, Professional Building, University Drive, Camarillo, CA 93012, USA

³Division of General Internal Medicine, Georgetown University Medical Center, 3800 Reservoir Rd. NW, Washington DC 20007, USA

⁴Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA

⁵Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Sixth Floor, Boston, MA, 02215, USA

author email corresponding author email

BMC Medical Education 2002, 2:1doi:10.1186/1472-6920-2-1


Published:	10 January 2002

Abstract

Background

Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course.

Methods

Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students.

Results

Average total OSCE score was 57% (range 39–75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p < .0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p < .0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p < .0001).

Conclusions

Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.