CREATING AN OBJECTIVE STRUCTURED CLINICAL EXAMINATION FOR THE INTERNAL-MEDICINE CLERKSHIP - PITFALLS AND BENEFITS

The objective-structured clinical examination (OSCE) is a useful tool in evaluating clinical competence. Traditional clinical-evaluation mea sures have been criticized as arbitrary and lacking reliability, where as written exams test primarily cognitive aspects. The OSCE focuses on learner actions rather than abstract knowledge and evaluates in a uni form fashion. A 15-station OSCE was created for an internal medicine j unior clerkship, based on predetermined skill and content goals. The e xams then were scored by a single, blinded reviewer, again in a predet ermined fashion. The OSCE has been studied in terms of reliability, co ntent validity, and construct validity. The exam has become accepted b y the department and has guided the continuing curricular development. The OSCE is not designed to measure all the domains of a learner's ed ucational process. However, when used in conjunction with other evalua ting mechanisms, it provides an objective outcome measure of the medic al education process.