The objective structured clinical examination revisited for postgraduate trainees in general practice

Birgitte Schoenmakers1 and Johan Wens2

1Academic Centre of General Practice, Department of Public Health and Primary Care, University of Leuven, Belgium

2Department of Public Health and Primary Care, Campus Drie Eiken, University of Antwerp, Belgium

Submitted: 02/07/2013; Accepted: 31/01/2014; Published: 04/03/2014

Int J Med Educ. 2014; 5:45-50; doi: 10.5116/ijme.52eb.f882

© 2014 Birgitte Schoenmakers & Johan Wens. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0

Objectives: To investigate if the psychometric qualities of an OSCE consisting of more complex simulated patient encounters remain valid and reliable in the assessment of postgraduate trainees in general practice.

Methods: In this intervention study without control group, the traditional OSCE was formally replaced by the new, complex version. The study population was composed by all postgraduate trainees (second and third phase) in general practice during the ongoing academic year. Data were handled and collected as part of the formal assessment program. Univariate analyses, the variance of scores and multivariate analyses were performed to assess the test qualities.

Results: A total of 340 students participated. Average final scores were slightly higher for third-phase students (t-test, p =0.05). Overall test scores were equally distributed on station level, circuit level and phase level. A multiple regression analysis revealed that test scores were dependent on the stations and circuits, but not on the master phase.

Conclusions: In a changing learning environment, assess-ment and evaluation strategies require reorientation. The reliability and validity of the OSCE remain subject to discussion. In particular, when it comes to content and design, the traditional OSCE might underestimate the performance level of postgraduate trainees in general practice. A reshaping of this OSCE to a more sophisticated design with more complex patient encounters appears to restore the validity of the test results.