The Integrated Direct Observation Clinical Encounter Examination (IDOCEE) - an objective assessment of students' clinical competence in a problem-based learning curriculum

Because of the well known, poor reliability and cost ineffectiveness of the traditional discipline-oriented type of long/short case clinical examinati on, the College of Medicine of the Arabian Gulf University in 1996 replaced this type of examination for its final MD Graduating Class by a performanc e-based clinical examination 'The integrated Direct Observation Clinical En counter Examination' (IDOCEE) in which the student's clinical competence is tested during his encounter with four or five real patients having a mix o f clinical problems under direct observation by a panel of between four and six examiners from different disciplines over a 2 hour period. Seventy fou r students were examined by 26 examiners. In order to test the students' an d examiners' satisfaction with this type of examination, a structured quest ionnaire was used. The response was as follows: 98% of the students were sa tisfied by the examination structure and organization, 94% with its effecti veness in resting student clinical competence, and 97% with the examiners a ttitude and approach; 96% of the examiners expressed satisfaction with the examination structure and organization and 97% with its ability to test cli nical competence. This experience indicates that the IDOCEE is a practical and cost-effective assessment tool of student's student's clinical competen ce, and it can replace the traditional discipline-based clinical examinatio ns.