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Related Experiment Videos

Objectivity in objective structured clinical examinations: checklists are no substitute for examiner commitment.

Tim J Wilkinson1, Christopher M Frampton, Mark Thompson-Fawcett

  • 1Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand. tim.wilkinson@chmeds.ac.nz

Academic Medicine : Journal of the Association of American Medical Colleges
|February 14, 2003
PubMed
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Examiners, not station design, are key to reliable objective structured clinical examinations (OSCEs). More checklist items reduce OSCE reliability and validity, emphasizing the need for engaged examiners.

Area of Science:

  • Medical Education
  • Assessment and Evaluation
  • Healthcare Professional Training

Background:

  • Objective Structured Clinical Examinations (OSCEs) are widely used to assess clinical skills.
  • Ensuring objectivity and reliability in OSCEs is crucial for accurate evaluation of medical trainees.
  • The relative contributions of station design and examiner factors to OSCE reliability remain an area of investigation.

Purpose of the Study:

  • To quantify the impact of examiners versus station construction on interrater reliability in OSCEs.
  • To determine the effect of objectification (e.g., checklist items) on station reliability and validity.
  • To explore specific examiner characteristics influencing interrater reliability.

Main Methods:

  • Analysis of examiner mark sheets from four annual OSCEs (1997-2000) at the University of Otago.

Related Experiment Videos

  • Random-effects analysis of variance was used to partition contributions of station construction and examiners.
  • Multiple linear regression analyzed the association of checklist items, examiner experience, and involvement in station construction with interrater reliability.

    • Main Results:

    • Examiners accounted for 89.9% of the variation in interrater reliability, while station construction and mark sheets contributed only 10.1%.
    • Increased number of checklist items per mark sheet negatively correlated with interrater reliability and station validity.
    • Examiner involvement in station construction positively correlated with interrater reliability; examiner experience showed no association.

    Conclusions:

    • Examiners are the primary drivers of objectivity in OSCEs, significantly outweighing the impact of mark sheets.
    • Reducing the number of checklist items may enhance, rather than decrease, OSCE reliability and validity.
    • Achieving high objectivity in OSCEs necessitates actively involved and diligent examiners.