Objective-Structured Clinical Assessment

9. Background: Ronald Harden introduced the Objective Structured Clinical Examination (OSCE) at 1970s as “an approach to the assessment of clinical competence in which the component of competence assessed in planned or structured way with the attention being paid to the objectivity of the examination”. It has been used to eradicate subjectivity that affect the most type of assessment by assessing knowledge, skills, attitudes, communication and professionalism.

In a typical OSCE first, the clinical competencies relevant to general practice that need to be assessed must be defined clearly. Then the competencies are broken down into different components such as history taking, physical examination, and communication skills, etc. A typical

examined the leniency and stringency in the membership of the royal colleges of physicians of the United Kingdom (MRCP) clinical examination to identify the amount of error variance. Data included first nine diets of clinical examination (PACES) between 2001 and 2004 by 10,145 candidates assessed by total 1,259 examiners. Each candidate was assessed by two examiners resulting in 142,030 marks. The authors used Multi facet Rasch Modeling (MFRM) to estimate the factors that lead to variance in the candidate scores. It was observed that about 87% of the main effect variance was due to differences in candidates levels, 1% due to stations differences while 12% of the differences due to leniency/stringency of the examiners. In this “golden” setup and preparation of a high-stake OSCE, examiner effect had a 12% impact on scores. Given rigorous standardization there still was a 4% shift in outcomes while most OSCEs do not use highly trained and monitored dual