|Objective Structured Clinical Examination (OSCE)|
A method introduced in 1972 as a more standardized way of assessing clinical competencies. It 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, and ability to make a differential diagnosis or plan treatment. The examiners carefully plan the tested areas and objectives of the test are identified and recorded. The clinical competency to be tested is broken down into its various components such as taking a history, auscultation of the heart, interpretation of an ECG, or making a conclusion on a basis of findings. Candidates rotate through a series of "stations", usually 12-20, and in a specified time perform a standardized task.
The format of individual OSCE varies significantly. Clinical models and standardized patients or simulated patients can be used to allow large numbers of students to be tested on the same clinical problem without causing fatigue or stress to real patients. Direct or indirect observations as well as checklists and rating scales measure the performance against predetermined standards resulting in a more objective examination than with traditional methods. This provides a more valid and more reliable examination permitting the move away from testing factual knowledge to testing a wide range of skills. The variables of the examiner and the patient are, to a large extent, removed. OSCE is particularly suited to situations where a pass/fail decision has to be taken and where a decision has to be made as to whether a student has reached a prescribed standard. It is cost-effective when many candidates are examined at once, as it is difficult to create and administer and requires resources and expertise. With succeeding examinations, less time is required and both time and effort can be reduced if a bank of objective test items and checklists is maintained.
Use of OSCE for formative assessment has great potential and value as the learners can gain insights into the elements making up clinical competencies as well as feedback on personal strengths and weaknesses. However, in the OSCE, the student's knowledge and skills are tested in compartmentalized fashion and he/she is not tested on the ability to look at a patient as a whole being. Still, OSCE may be combined with other forms of assessment, such as the clerking of cases in the wards. The previously used term for this assessment method was Multiple Station Exercises/Exam (MSE).