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The Reliability of 2-Station Clerkship Objective Structured Clinical Examinations in Isolation and in Aggregate
Aaron W Bernard1, Richard Feinn1, Gabbriel Ceccolini2
1Department of Medical Sciences, Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, CT, USA.
Journal of Medical Education and Curricular Development
|August 7, 2019
Summary
Two-station objective structured clinical examinations (OSCEs) show poor reliability for individual clerkships. However, aggregating OSCE data across multiple blocks demonstrates good reliability for assessing student clinical skills.
Area of Science:
- Medical Education Research
- Clinical Skills Assessment
- Psychometrics in Education
Background:
- Most U.S. medical schools utilize 5-10 station Objective Structured Clinical Examinations (OSCEs) post-clerkship.
- Investigated a novel 2-station OSCE structure per clerkship.
- Examined reliability for composite grading and as an alternative to end-of-year exams.
Purpose of the Study:
- Determine the reliability of 2-station clerkship OSCEs in isolation.
- Assess the reliability of aggregated OSCE data.
- Inform composite clerkship grading and potential end-of-third-year examination alternatives.
Main Methods:
- Analyzed 2017-2018 clerkship OSCE data from 93 students.
- Calculated generalizability coefficient (ρ²) and index of dependability (φ).
- Employed variance components analysis for isolated and aggregated data.
Main Results:
- Individual 2-station clerkship OSCEs had low reliability (average ρ² = .47).
- Student-station interaction was the largest variance component, indicating performance inconsistency.
- Aggregated clerkship OSCEs showed good reliability (ρ² = .80), with significant student-by-block variance (42.6%).
Conclusions:
- Two-station OSCEs possess poor to fair reliability, impacting composite grade weighting.
- Aggregating OSCE data across blocks yields good reliability.
- Student performance variation across blocks suggests advantages over single-day examinations.
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