The Associations Between Clerkship Objective Structured Clinical Examination (OSCE) Grades and Subsequent Performance

Area of Science:

• Medical Education Research
• Clinical Skills Assessment
• Graduate Medical Education

Background:

• Limited research correlates undergraduate Objective Structured Clinical Examinations (OSCE) with future performance.
• Existing studies often use small sample sizes or single clerkships.
• Few studies link simulated clinical encounters to actual patient care outcomes.

Purpose of the Study:

• To investigate the association between medical students' OSCE performance during Obstetrics/Gynecology and Family Medicine clerkships and their subsequent performance.
• To correlate OSCE scores with United States Medical Licensing Examination (USMLE) Step 2 and Step 3 scores.
• To examine the relationship between OSCE performance and Postgraduate Year 1 (PGY-1) program director evaluations.

Main Methods:

• Analysis of data from USU graduating classes of 2007-2011.
• Correlational analysis between clerkship OSCE grades and USMLE Step 2 CK, Step 2 CS, Step 3 scores.
• Contingency table analysis for associations between poor OSCE performance and failing Step 3 or receiving poor PGY-1 ratings.

Main Results:

• Weak correlations were found between clerkship OSCE grades and most subsequent performance measures.
• Strongest correlations were observed with USMLE Step 2 CS Integrated Clinical Encounter, Step 2 CS, and Step 3 scores.
• Significant associations were found between poor OSCE performance and poor PGY-1 program director ratings for Medical Expertise and Professionalism.

Conclusions:

• OSCEs during clinical clerkships provide limited validity evidence for predicting future medical performance.
• The findings suggest OSCEs have some association with subsequent licensing exam and program director evaluations.
• Further research is needed to fully understand the predictive value of OSCEs in medical education.