Reliability and Validity of an Objective Structured Clinical Examination for Assessing the Clinical Performance of Residents

doi:10.1001/archinte.1990.00390150069014

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Vol. 150 No. 3, March 1990

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Reliability and Validity of an Objective Structured Clinical Examination for Assessing the Clinical Performance of Residents

Emil R. Petrusa, PhD; Thomas A. Blackwell, MD; Michael A. Ainsworth, MD

Arch Intern Med. 1990;150(3):573-577.

Abstract

• Clinical performance of residents should be assessedas reliably and validly as possible. This study investigatedthe reliability and validity of an objective structured clinicalexamination (OSCE) for assessing clinical performance of internalmedicine residents. Residents were required to take a 17-patientOSCE in their first and second year. Reliability of the OSCEwas 0.40. Validity studies indicated second-year students weresignificantly better than third-year students for five of sixOSCE skill scores; first-year students were significantly betterfor three scores. Resident's scores for diagnosis, plan, andtotal significantly increased on their second OSCE. Generallyfaculty overall ratings of residents' clinical performance didnot correlate with OSCE scores. American Board of Internal Medicinecertifying examination scores were consistently positively correlatedonly with diagnosis. This 17-case OSCE is a feasible methodfor obtaining moderately reliable, valid data not availablefrom other sources about the clinical performance of residents.More cases should be added to increase its reliability.

(Arch Intern Med. 1990;150:573-577)

Author Affiliations

From the Department of Internal Medicine (Drs Petrusa, Blackwell, and Ainsworth) and Office of Educational Development (Dr Petrusa), University of Texas Medical Branch, Galveston.

Footnotes

Accepted for publication August 29,1989.

Read before the Newer Developments in the Assessment of ClinicalCompetence conference, Ottawa, Ontario, Canada, July 29,1987.

Reprint requests to 441 Clinical Sciences Bldg G69, Universityof Texas Medical Branch, Galveston, TX 77550 (Dr Petrusa).

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