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Cost analysis of objective structured clinical examinations
1University of Texas Southwestern Medical Center at Dallas Southwestern Medical School 75235-9065, USA.
Summary
Implementing objective structured clinical examinations (OSCEs) is financially feasible for academic institutions. Cost-effective strategies for personnel and standardized patients (SPs) can minimize expenses for these crucial clinical assessments.
Area of Science:
- Medical Education
- Health Professions Education
- Clinical Assessment
Background:
- Costs for objective structured clinical examinations (OSCEs) and patient-centered exams are not well-established.
- Published cost estimates vary widely ($21-$1,000+ per examinee) due to inconsistent definitions and lack of cost-minimization strategies.
Purpose of the Study:
- To establish a clear definition of OSCE costs.
- To identify and analyze cost-saving strategies for OSCE implementation.
- To assess the financial feasibility of developing and implementing OSCEs at academic institutions.
Main Methods:
- Conducted a literature review (1993-94) to define and categorize OSCE costs.
- Subcategorized costs into personnel, standardized patients (SPs), and administration.
- Analyzed methods for minimizing expenses within each subcategory.
Main Results:
- Personnel costs (physicians, trainers, support) are negligible if part of academic responsibilities.
- SP costs can be reduced by using experienced patients and professional personnel in teaching/evaluative roles.
- Administrative costs are fixed; significant savings are not feasible. Detailed cost analysis of a comprehensive OSCE is presented.
Conclusions:
- Developing and implementing OSCEs is financially feasible for academic institutions.
- Cost-containment strategies, particularly for SPs and personnel, are key to feasibility.
- Psychometrically valid OSCEs can be achieved with minimized costs.