ASSESSING CLINICAL COMPETENCE OF MEDICAL-STUDENTS IN WOMENS HEALTH-CARE - USE OF THE OBJECTIVE STRUCTURED CLINICAL EXAMINATION

Objective: To assess clinical competency of third-year medical student s completing a problem-oriented, primary care emphasis clerkship in ob stetrics and gynecology using an objective structured clinical examina tion, and to determine the feasibility of implementing the objective s tructured clinical examination in the curriculum. Methods: Sixteen gro ups of third-year medical students were evaluated prospectively on the ir exit performances with a six-station objective structured clinical examination designed to test clinical competency in basic primary care obstetrics-gynecology. Consistency of scores across stations, differe nces in performance for separate groups, and relationship of objective structured clinical examination scores compared with other indicators of medical proficiency, such as written examinations and faculty eval uations, were assessed. Results: One hundred ninety-eight students wer e evaluated over 25 months. Test reliability across stations revealed alpha values ranging between .50 and .56. Correlations between perform ance on the objective structured clinical examination and the written test (r = .10) were low, demonstrating that the objective structured c linical examination clearly tests a separate domain of student capabil ity. Cost of the objective structured clinical examination was $81.66 per student. Conclusion: The objective structured clinical examination is a reliable and valid test of the clinical competence of medical st udents in the primary health care of women. It provides information th at is not obtained by more traditional assessment modalities at a reas onable cost. (Obstet Gynecol 1998;92:1038-43. (C) 1998 by The American College of Obstetricians and Gynecologists.)