DEVELOPMENT OF AN OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) FOR PHYSICAL MEDICINE AND REHABILITATION RESIDENTS

Clinical competency is poorly measured by knowledge-based written exam inations. A five-station, four-interstation objective structured clini cal examination (OSCE) has been developed in consultation with the Nat ional Board of Medical Examiners as a pilot study to standardize asses sment methods that serve to evaluate the clinical competency of senior physical medicine and rehabilitation residents. Various stations demo nstrating musculoskeletal and neurologic conditions commonly encounter ed in physiatric practice were included, incorporating the use of stan dardized patients into the OSCE format. This is a descriptive study of individual stations-evaluated history-taking, physical examination, a nd communication skills, whereas the interstations measured the reside nts' ability to write therapy and prosthetic/orthotic prescriptions, a s well as interpret x-ray and electrodiagnostic data. The OSCE program development including case background, principal tasks, time allotmen t, evaluation objectives, performance criteria, therapeutic plan, stan dardized patients case descriptions, and assessment checklists as well as the training procedure is discussed. Additionally, cost analysis a nd scheduling issues are reviewed. This information should aid other t raining programs or consortiums in developing similar clinical evaluat ion tools.