Objective Structured Clinical Examination (OSCE)
This is a form of assessment commonly used in medical schools because it allows students to practice and demonstrate their clinical skills in practical and standardized medical scenarios. Even though somewhat unique to medical education, the concept can be replicated in other fields.
The examination room is demarcated into different (rest) stations forming a circular circuit. At each station, there is an assessor and students are assessed on different and specific (clinical) competencies such as communication skills, writing prescription and providing basic life support. Each task is timed, usually at a maximum of 5 minutes.
Rotating in a sequence, students start at different stations and progress until they have completed all tasks. We use OSCE as a summative benchmark assessment in the first four years of medical school.
When used to assess medical students, OSCEs focus on the development and demonstration of competencies such as:
- Communication,
- Patient history taking and note keeping,
- Physical examination,
- Infection control,
- Clinical reasoning,
- Collaboration with colleagues,
- Chair-side manner with patients and colleagues
- Medical knowledge and the integration of all these skills
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It is a tried and tested method of assessment supported by good psychometric data
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Robust, transparent and engaging
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Students demonstrate practical skills in real life scenarios without posing a danger of injury to patients
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Students receive one-on-one feedback on their OSCE performance
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Gives a wider blueprint of the curriculum and allows for various subjects to be covered/assessed in no more than 1 hour 30 minutes using this short circuit method
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Students all attempt the same scenarios therefore the assessment is fair
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It allows staff to independently bring expertise to the questions in a truly collaborative effort (amongst staff)
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The assessment is labour intensive. It requires as many assessors as there are stations
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Because students are observed as they perform tasks, their performance may be affected by factors such as anxiety
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Time for setting up can be a limiting factor specifically in a clinical environment where a benchmark standard of assessment is required
Students receive one-on-one feedback on their performance to help them refocus on what needs to be improved
The nature of the assessment requires that it be conducted in-person but with the advanced technological capabilities available today, assessment can be adapted and facilitated online
The way the assessment is set up limits integrity challenges.