Surgery residents' perception of the Objective Structured Clinical Examination (OSCE)

Beginning in July 2003, residency programs will be required to incorporate new educational assessment methods as defined by the Accreditation Council for Graduate Medical Education (ACGME) outcome initiative. The Objective Structured Clinical Examination (OSCE) is an assessment tool that is favorably viewed by the ACGME. Our institution has utilized the OSCE for evaluation of surgery trainees since 1996. Despite the positive acceptance of the OSCE by students, residents expressed dissatisfaction with the examination. This study was therefore undertaken to specifically evaluate resident perception of the OSCE.

Two sequential surveys were administered to surgery residents at the Medical College of Ohio. Response of medical students to a standard survey following completion of the OSCE was tabulated.

On the first, general survey, residents felt that the OSCE was not an adequate measure of either clinical (15 of 17 residents) or technical (15 of 18 residents) skills; 14 of 16 residents felt that the OSCE should not be used when considering promotion. When specifically queried in a follow-up survey, residents indicated that the OSCE was an adequate measure of clinical knowledge (2.2 +/- 0.3); however, most still felt that the OSCE should not be used when considering promotion (4.3 +/- 0.3). (Scores = mean +/- SEM on a Likert scale where 1 = strongly agree and 5 = strongly disagree). By contrast, 97.6% of 663 medical students surveyed (September 1996 through February 2002) felt the OSCE was useful.

The OSCE has been shown to be a reliable and valid measure of basic clinical and technical competence. Despite our residents' current perception, we believe that the OSCE is an important method for resident evaluation, particularly within the context of the current ACGME outcome initiative.