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Competency domains in an undergraduate Objective Structured Clinical Examination: their impact on compensatory
Ashley Reece1, Eddie M K Chung, R Mark Gardiner
1Department of Paediatrics, Watford General Hospital, Watford, UK. ashley.reece@doctors.org.uk
Medical Education
|May 17, 2008
Summary
This study on objective structured clinical examinations (OSCE) found that competency domains are valid. Allowing compensation within domains, but not across them, ensures a more robust medical student assessment.
Area of Science:
- Medical Education
- Assessment and Evaluation
Background:
- Undergraduate medical students undergo high-stakes objective structured clinical examinations (OSCE) after clinical attachments.
- Two hypotheses were tested regarding station grouping and performance compensation.
Purpose of the Study:
- To determine if OSCE stations map to identifiable competency domains using factor analysis.
- To investigate the impact of performance compensation across domains on student assessment outcomes.
Main Methods:
- Confirmatory factor analysis was used to compare 1-factor and 3-factor models for 10 OSCE stations.
- Data from 647 medical students across 5 examination sittings were analyzed.
Main Results:
- The 3-factor model demonstrated a significantly better fit to the data, supporting distinct competency domains.
- Allowing compensation across all domains significantly reduced the failure rate compared to domain-specific failures.
Conclusions:
- The study validates previously identified competency domains for undergraduate OSCEs.
- Implementing compensation within, but not between, competency domains enhances assessment robustness and validity.
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