"Shadow" OSCE examiner. A cross-sectional study comparing the "shadow" examiner with the original OSCE examiner...

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Healthcare Professional Training

Background:

• Effective feedback is crucial for learning but often lacking in medical education.
• Objective Structured Clinical Examinations (OSCEs) are standard assessment tools.
• Learner-teacher feedback gaps necessitate innovative assessment strategies.

Purpose of the Study:

• To introduce and evaluate a modified examiner role, the "shadow" examiner, within the OSCE format.
• To compare the reliability and impact of the "shadow" examiner with the traditional "fixed" examiner.
• To analyze differences in assessment scores across cognitive and affective domains.

Main Methods:

• A "shadow" examiner role was developed and implemented in OSCEs.
• 415 sixth-year medical students participated; 316 were assessed by both "shadow" and "fixed" examiners.
• Statistical analyses included Pearson correlation, linear regression, t-tests, and Bland-Altman plots, with domain-specific item classification.

Main Results:

• High correlations were found between "shadow" and "fixed" examiner global scores.
• Cognitive domain scores showed higher correlations than affective domain scores.
• No significant differences in mean global scores were observed; "shadow" examiners rated affective scores slightly higher, but the difference was minor.

Conclusions:

• The "shadow" examiner role does not introduce significant bias compared to the traditional OSCE format.
• This modified approach offers potential for improved formative feedback in clinical performance assessments.
• The strategy may enhance the quality and quantity of feedback provided to medical trainees.