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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Evaluation of clinical competence: the gap between expectation and performance
1Department of Pediatrics, Henry Ford Health System, Detroit, MI, USA.
Pediatrics
|February 1, 1996
Summary
Pediatric residents often failed Objective Structured Clinical Examinations (OSCEs), despite good performance on other evaluations. This highlights a significant gap between expected and actual resident performance in clinical skills.
Area of Science:
- Medical Education
- Pediatric Residency Training
- Clinical Skills Assessment
Background:
- Objective Structured Clinical Examinations (OSCEs) are a common tool for evaluating resident performance.
- Faculty expectations for resident performance may not align with actual demonstrated skills.
Purpose of the Study:
- To evaluate a 3-year experience with OSCEs in a pediatric residency program.
- To compare faculty expectations with resident performance on OSCEs.
Main Methods:
- Descriptive analysis of resident performance measures over three years.
- Utilized 36-42 five-minute stations to assess various clinical skills.
- Compared OSCE results with other performance indices.
Main Results:
- OSCEs demonstrated content, construct, and concurrent validity with high reliability.
- A high percentage of residents (40%-96%) scored below minimum pass levels.
- Third-year residents had the highest failure rates on OSCEs, yet performed well on other assessments.
- Residents scored significantly lower on data application than data gathering skills.
Conclusions:
- Significant discrepancies exist between faculty expectations and resident performance on OSCEs.
- A notable gap was observed between residents' data gathering and data application skills.
- Recommendations include shifting towards more clinically oriented and learner-directed educational and evaluation strategies.
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