The use of an objective structured clinical examination (OSCE) for formative and summative assessment in a general practice clinical attachment and its relationship to final medical school examination performance

Objectives To report the use of OSCEs for both formative and summative purp oses within a general practice undergraduate clinical attachment and to com pare student performance in the departmental OSCEs with that of their final medical school examinations. Methods Twenty-eight students rotated through the attachment and undertook pre- and post-attachment OSCEs of similar format but different content. Res ults were analysed to determine relationships between mean scores in the tw o OSCEs and student performance in their final medical school MBBS examinat ions. Results There was a marked improvement in all OSCE station scores. Pre-atta chment scores for those stations measuring physical examination and problem -solving skills were unrelated to-prior clinical experience. Postattachment OSCE mean scores were significantly correlated with final examination OSCE and total mean scores. Conclusion The general practice attachment appears to upgrade those clinica l skills measured by the pre- and post-attachment OSCE, however, there was no control group of students. Problem-solving and focused physical examinat ion skills need to be targeted by all undergraduate clinical departments. T he department's post-attachment OSCE and total assessment results are predi ctors of final examination OSCE and total results. The use of pre- and post -attachment OSCEs facilitates both students' formative learning processes a nd the department's evaluation of its educational programme.