USING AN OBJECTIVE STRUCTURED CLINICAL EXAMINATION TO EVALUATE COMPETENCE IN SPORT MEDICINE

This article discusses the development, format, administration and sco ring of the objective structured clinical examination (OSCE) to evalua te competency in sport medicine. The credentials committee of the Cana dian Academy of Sport Medicine has developed an examination to evaluat e the competency of practicing physicians in the field of sport medici ne. The examination is based on a sport medicine matrix that includes five areas: (a) clinical patient care, (b) team and event coverage, (c ) medical/legal issues, (d) teaching and administration, and (e) resea rch. The emphasis is on clinical patient care followed by team and eve nt coverage, with the other three areas having a lesser degree of impo rtance. The OSCE format consists of a number of stations or scenarios based on this matrix. The candidates are evaluated on a check list tha t reflects the emphasis of each station. A typical clinical patient ca re problem includes check list items related to the history, physical examination, investigations, diagnosis, and treatment. The candidates are also evaluated for their attitudes and techniques on each station. The examination includes volunteer examiners and patients both simula ted and real. The candidates are evaluated through the use of checklis ts that are filled in by the examiners on optical scoring sheets. Thes e are collated and analyzed to generate comparisons between candidates and to determine the psychometric properties of the overall examinati on. The examination has consistently scored reliability coefficients o f 0.8 or greater. The 1993 examination demonstrated reliability coeffi cients of 0.89-0.97. Interrater reliability was also calculated, and t hese values ranged from 0.85 to 0.99. The examination also reflects bo th face and content validity. Construct or predictive validity has yet to be determined. In conclusion, this examination, as a method of ass essing competency in sport medicine, has demonstrated excellent psycho metric properties compared to other similar methods of evaluation.