Objective structured clinical examination use in advanced orthodontic dental education

Continuous evaluation of residents and the advanced education curriculum is required to maintain the quality of a program and ensure appropriate accreditation status. The purpose of this project was to describe the process of introducing the objective structured clinical examination (OSCE) into an advanced orthodontic education program and to evaluate its impact on the curriculum.

To determine the content of the examination, 60 orthodontic practitioners were consulted to identify the most important clinical skills that an entry-level practitioner must be able to perform proficiently. From 18 critical clinical skills, 13 were evaluated by the OSCE in the areas of diagnosis, clinical evaluation and synthesis, and orthodontic technique. The OSCE was given to 3 classes of residents each year for 3 years (n = 46).

The classes were tracked longitudinally, and the students' levels were evaluated cross-sectionally. Curriculum changes were evaluated for impact in areas of deficiency. There were no significant correlations between student confidence and performance or faculty prediction of proficiency and performance beyond the first year. Great gains in performance were observed between the first and second years of the 3-year program. All skills did not reach proficiency levels, and peak performance did not always occur during the third year. Some curriculum changes were fruitful, and others were not sustained by improved performance.

An OSCE can provide important information regarding students and the curriculum in a clinically meaningful way that might be otherwise unattainable.