Impacting faculty teaching and student performance: Nine years' experiencewith the Objective Structured Clinical Examination

Background: The impetus for administering the 2nd-year Objective Structured Clinical Examination (OSCE) came fr om the great variability in student pe rformance observed by 3rd-year clerkship directors. Purpose: To document the effects of the OSCE on faculty teaching, student p erformance, and the curriculum over 9 years of administration of the examin ations to more than 1,000 second-year medical students. Method: A 20-station OSCE was administered to all medical students at the e nd of their 2nd year. Using predetermined criteria, clinical faculty sewed as evaluators ill each station. A mix of 1st-, 3rd-, and 4th-year medical s tudents were recruited to serve as simulated patients. Faculty evaluators a nd examinees completed a questionnaire evaluating their experience with the OSCE. Students received a report card of their performance. Small-group le aders of the Introduction to Clinical Medicine course received feedback on their group's performance on each station compared to the class mean. Summa tive data on class performance was reported to the curriculum committee. Th e academic status committee received data on students who performed unsatis factorily. Results: Faculty and examinee ratings of the OSCE experience were very posi tive. Over the 9-year period, student performance improved showing less var iability and significantly fewer failed stations. Conclusion: The OSCE has proven to be a technically feasible, authentic eva luation method yielding valuable information for decisions regarding studen t performance, faculty teaching, and curriculum planning.