Reliability of clinical oral examinations re-examined

Many medical schools still use oral examinations for the evaluation of clin ical competence of students in their clerkship although it has been proven that ovals have poor reliability. This study investigates the feasibility a nd reliability of multiple oral examinations. Students in the last week of their Internal Medicine clerkship in an outpatient clinic were given severa l patient-based oral examinations. The students performance was rated on a list of items reflecting clinical competence, A global judgement of the stu dent's performance was also given. The results indicate that it is possible to increase the number of orals and the number of examiners in the day-to- day practice of an outpatient clinic moderately, The reliability when using a number of ovals is better than the reliability of the common single oral examination, The reliability using global judgements appeared to be better than the reliability of averaged item scores.