Search

Abdullah A Yousef,1,2 Bassam H Awary,1 Faisal O AlQurashi,1 Waleed H Albuali,1 Mohammad H Al-Qahtani,1 Syed I Husain,2 Omair Sharif2 1Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Vice Deanship for e-learning, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Faisal O AlQurashiDepartment of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O Box: 11286, Dammam, 31453, Saudi Arabia, Tel +966555078804, Fax +966138955088, Email Faisal.alqurashi@yahoo.comPurpose: The Objective Structured Clinical Examination (OSCE) is a standard academic assessment tool in the field of medical education. This study presents an innovative method for digitizing OSCE evaluation system for medical students and explores its efficacy compared to the traditional paper-based system, through the analysis of a User Satisfaction Survey.Methods: A cross-sectional, questionnaire-based study involving a User Satisfaction Survey to evaluate assessors’ attitudes toward and acceptance of the Computerized Web-based OSCE Evaluation System (COES) was used. Fifth-year medical students at a College of Medicine were assessed clinically through their 2019 end-of-year OSCE examination by 30 examiners in five different OSCE stations. The traditional paper-based stations were converted into an online electronic version using QuestionPro software. Answers were filled in using smart tablets (iPads). QR codes were used for students’ identification at each station to fully digitize the process and save time. After the completion of the exam, a User Satisfaction Survey was sent electronically to all examiners to evaluate their experiences with the new system.Results: The response rate for the survey was 100% with an internal consistency of 0.83. Almost all the examiners (29, 97%) were satisfied with the application of the COES. Further, 72% of the examiners indicated that the electronic system facilitated the evaluation of the students’ skills, and 84% found using a smart device (iPad) was easier than using a paper form. All examiners expressed their preference for using the electronic system in the future.Conclusion: Users were satisfied with the utilization of the customized COES. This concept of fully digitizing the OSCE assessment process shortened the time needed for both the analysis of results and providing students with feedback. Further observational studies are needed to assess examiners’ behaviors when using this methodology.Keywords: academic performance, clinical competency, clinical skills, medical education, undergraduate, Saudi Arabia

BACKGROUND The goal of the present study was to evaluate whether children as standardized patients (SPs) for a summative OSCE station fulfills the Ottawa criteria for good assessment. METHODS Data for participating students (n���=���124), raters (n���=���11), and children (n���=���127) were collected using questionnaires (students, raters), focus groups (raters), and interviews (children, raters). The psychometrics (including reproducibility) of this OSCE station were also analyzed according to quality indices. RESULTS Validity, reproducibility, feasibility, educational effect, and acceptability were attained for this OSCE station. Students and raters accepted the new approach and evaluated it as fair and acceptable, with realism and validity. This OSCE station had a perceived positive educational effect for ���30% of the students, who expected child SPs. Raters stated it as feasible to involve children. The children enjoyed their participation, which was acceptable and feasible. Statistical measures were in the recommended ranges and showed reproducibility. CONCLUSION Children as SPs for a summative OSCE station was perceived as fair, acceptable, realistic, and feasible by all stakeholders, and with perceived positive educational impact. This pediatric OSCE station fulfilled five of the seven Ottawa criteria for good assessment. Further studies are needed to investigate different pediatric stations.

Published online: 8 October 2021 Despite the Lisbon Treaty's modifications in the foreign and security policy domain, the EU has frequently relied on third parties to address external conflicts and crises. Using the Ukrainian conflict as a case study, this article adopts the orchestration model to explain why and how the EU enlists intermediary actors over which it has no formal control to pursue its objectives. It finds that in this conflict the EU outsourced part of its crisis management activities to the Organization for Security and Co-operation in Europe because it lacked the civilian and military capabilities, as well as the regulatory competence and reputation to challenge Russia. Indeed, the Ukrainian case shows that orchestration has emerged as a crucial governance arrangement for the functioning of EU crisis management, raising serious questions about the EU overall capacity to act as a security provider in an international system marred by contestation and hard security concerns.

Progress testing aligns well with competency-based medical education (CBME) frameworks, which stress the importance of continuous improvement. Entrustment is a useful assessment concept in CBME models. The purpose of this study was to explore the use of an entrustability rating scale within the context of an objective structured clinical examination (OSCE) Progress Test.A 9-case OSCE Progress Test was administered to Internal Medicine residents (PGYs 1-4). Residents were assessed using a checklist (CL), global rating scale (GRS), training level rating scale (TLRS), and entrustability scale (ENT). Reliability was calculated using Cronbach's alpha. Differences in performance by training year were explored using ANOVA and effect sizes were calculated using partial eta-squared. Examiners completed a post-examination survey.Ninety one residents and forty two examiners participated in the OSCE. Inter-station reliability was high for all instruments. There was an overall effect of training level for all instruments (An entrustability scale can be used in an OSCE Progress Test to generate highly reliable ratings that discriminate between learners at different levels of training.

In this paper, we review the results of a qualitative thematic analysis exploring student reflections during an Objective Structured Clinical Examination Adapted for Social Work (OSCE-SW). Students...

Introduction: There has been a long-running debate about the validity of item-based checklist scoring of performance assessments like OSCEs. In recent years, the conception of a checklist has devel...

Background: The objective structured clinical examination (OSCE) is the gold standard and universal format to assess the clinical competence of medical students in a comprehensive, reliable and valid manner. The clinical competence is assessed by a team of many examiners on various stations of the examination. Therefore, it is found to be a more complex, resource- and time-intensive assessment exercise compared to the traditional examinations. Purpose: The objective of this study was to determine the final year MBBS students’ and OSCE examiners’ perception on the attributes, quality, validity, reliability and organization of the Medicine and Therapeutics exit OSCE held at the University of the West Indies (Cave Hill) in June 2017. Methods: At the end of the OSCE, students and examiners were provided with a questionnaire to obtain their views and comments about the OSCE. Due to the ordinal level of data produced by the Likert scale survey, statistical analysis was performed using the median, IQR and chi-square. Results: A total of 52 students and 22 examiners completed the questionnaire. The majority of the students provided positive views regarding the attributes (eg, fairness, administration, structure, sequence, and coverage of knowledge/clinical skills), quality (eg, awareness, instructions, tasks, and sequence of stations), validity and reliability (eg, true measure of essential clinical skills, standardized, practical and useful experiences), and organization (eg, orientation, timetable, announcements and quality of examination rooms) of the OSCE. Similarly, majority of the examiners expressed their satisfaction with organization, administration and process of OSCE. However, students expressed certain concerns such as stressful environment and difficulty level of OSCE. Conclusion: Overall, the OSCE was perceived very positively and welcomed by both the students and examiners. The concerns and challenges regarding OSCE can be overcome through better orientation of the faculty and preparation of the students for the OSCE.

We investigated the feasibility of a formative objective structured clinical examination adapted for social work (OSCE-SW) with a parent–bisexual child dyad and evaluated self-efficacy and performa...

This is a welcome volume. But despite its august title, and comprising 15 chapters which cannot each be reviewed, approaching 400 pages, does this not sound and feel like a substantial work of lite...

This article presents the results of two pilot studies focused on examining social work students’ ability to interview two clients at once to provide evidence supporting the use of new dyadic subsc...

Introduction: Examiner based variance can affect test taker outcomes. The aim of this study was to investigate the examiner-based effect of DRIFT or differential rater functioning over time.Methods...

Objective structured clinical examinations (OSCEs) are high-stakes, stressful assessments for both examiners and students under any circumstances. During the COVID-19 global pandemic, a UK wide lockdown resulted in a temporary postponement of all veterinary nursing practical assessments, until appropriate procedures and government sanctions permitted OSCEs to be carried out in a safe environment. This is a reflective account of holding OSCE style assessments using a social distancing protocol, highlighting the positive impact these measures had on student assessment experience.

A two-station (scenario) Objective Structured Clinical Examination (OSCE) was developed and tested for validity and reliability for assessing social work engagement skills in public child welfare. ...

This piece examines practices of the European Union (EU) and the Organization for Security and Co-operation in Europe (OSCE) in dealing with secessionist entities in the post-Soviet space. The stud...

The Objective Structured Clinical Examination (OSCE) is used globally for both high and low stakes assessment. Despite its extensive use, very few published articles provide a set of best practices for developing an OSCE, and of those that do, none apply a modern understanding of validity. This article provides 12 tips for developing an OSCE guided by Kane's validity framework to ensure the OSCE is assessing what it purports to measure. The 12 tips are presented in the order they would be operationalized during OSCE development.

Election observation has become a common practice in international politics and is widely perceived as an instrument to maintain and safeguard electoral integrity. International and citizen election observation practices developed in parallel to provide scrutiny of electoral processes from various perspectives, and both are based on international obligations, standards, and commitments. This article analyses whether international and citizen observation is actually possible and encouraged in states with broadly perceived electoral integrity that promote election observation in other countries. The 1990 OSCE’s Copenhagen Document, which all participating states have committed to, recommends both international and citizen election observation. International election observation activities by the OSCE/ODIHR have been increasingly dedicated to European countries with established traditions of holding democratic elections. The comparative analysis offered in this article is based on 200 OSCE/ODIHR repo...

Soon after the breakdown of the Soviet Union in 1991, a civil war started in Tajikistan (1992–97). This was also the period when a number of international organizations arrived in the country to distribute humanitarian assistance and assist in conflict resolution and stabilization. After the UN, the Organization for Security and Co-operation in Europe (OSCE) was the second key organization which appeared in the conflict-stricken country. Like other key international organizations in Tajikistan, the OSCE, which has been in the country since 1994, has seen a shift in its original functions of monitoring and emergency assistance. Some see its avowed objectives in the new century as formalistic, virtual and ineffective. By capturing perceptions of foreign assistance to Tajikistan among employees of the OSCE and other international organizations, NGO workers, government officials and ordinary citizens, this article explores how Tajikistan ‘socialized’ the OSCE, making the organization simultaneously a ...

Faced with low numbers of women in national legislatures, election observers would be expected to recommend action for improving equal representation. With data from nearly 100 election observation reports of the OSCE Office for Democratic Institutions and Human Rights, this article explores how frequently and how strongly observers recommended taking measures to improve participation of women candidates in national legislative elections. It was found that the number of such recommendations has grown over the past decade, but with a tendency to use weak language. In examining these recommendations, this article argues that observers should be more consistent and insistent in promoting equal opportunities for women candidates.

Norm contestation by local actors has emerged in recent years as an explanation for the failure of norm diffusion. This article contributes to the literature on norm contestation by analysing how norms diffused by the Organisation for Security and Cooperation in Europe (OSCE) pertaining to election observation and free and fair voting are re-constituted and contested by domestic actors in Kazakhstan. The study contributes to the idea of ‘constitutive localisation’ by emphasising a more fundamental level of disagreement beyond just congruence between the diffused norm and local beliefs; by demonstrating contestation can occur in the later stages in the norm diffusion cycle; by focusing on the micro-politics of contestation by local actors involved in the implementation of diffused norms; and by revealing how norm contestation is not necessarily a process of emancipatory politics, but a strategic act to serve authoritarian consolidation. Utilising a four-fold framework, the analysis illustrates how norms, while initially accepted by Kazakhstani authorities, are reconstituted through political discourse and/or practice, creating the moment of contestation. While this contestation is instrumentalised by political elites for their own advantage, it also remains an important element of agency within a normative order which they had little previous control over.

Construct: We investigated the extent of the associations between medical students' clinical competency measured by performance in Objective Structured Clinical Examinations (OSCE) during Obstetrics/Gynecology and Family Medicine clerkships and later performance in both undergraduate and graduate medical education.There is a relative dearth of studies on the correlations between undergraduate OSCE scores and future exam performance within either undergraduate or graduate medical education and almost none on linking these simulated encounters to eventual patient care. Of the research studies that do correlate clerkship OSCE scores with future performance, these often have a small sample size and/or include only 1 clerkship.Students in USU graduating classes of 2007 through 2011 participated in the study. We investigated correlations between clerkship OSCE grades with United States Medical Licensing Examination Step 2 Clinical Knowledge, Clinical Skills, and Step 3 Exams scores as well as Postgraduate Year 1 program director's evaluation scores on Medical Expertise and Professionalism. We also conducted contingency table analysis to examine the associations between poor performance on clerkship OSCEs with failing Step 3 and receiving poor program director ratings.The correlation coefficients were weak between the clerkship OSCE grades and the outcomes. The strongest correlations existed between the clerkship OSCE grades and the Step 2 CS Integrated Clinical Encounter component score, Step 2 Clinical Skills, and Step 3 scores. Contingency table associations between poor performances on both clerkships OSCEs and poor Postgraduate Year 1 Program Director ratings were significant.The results of this study provide additional but limited validity evidence for the use of OSCEs during clinical clerkships given their associations with subsequent performance measures.

The voice of the child is increasingly recognized as important, as summed up in the Department of Health report "No decision about me, without me". In medical education, however, the child's voice is little heard: often in a pediatric OSCE, the examiner assigns a mark for the child.To explore whether children can contribute meaningfully to summative scoring of student performance.We studied this in two phases: first we compared child scores (CSs) to examiner predictions of the child scores (EPCS), and other simulated patient (SP) scores within a single exam. Then we looked at CS over a further 4 exams.The Pearson correlation between CS and EPCS was 0.40 (p 0.001), therefore EPCS accounted for 16% of variation in CS. Across 4 exams, the mean CS was higher than the mean adult SP score: exploratory factor analysis indicated that both may be measuring the same characteristic. Cronbach's alpha (0.66 to 0.76) did not significantly increase when SP scores (including CS) were removed.Although there was some correlation between CS and EPCS, pediatricians could not accurately predict CS. We conclude that the child's voice can and should be heard within the OSCE marking process.

The Helsinki Accords resonated with dissident movements in the Soviet Bloc that had reconstructed a classical liberal approach to human rights. Human rights campaigns on both sides of the Iron Curtain emphasized civil and political rights. But human rights revisionism, expanding the scope of human rights, was growing in international institutions. In 1993, the international community embraced the concept of the ‘indivisibility’ of human rights. An expansive, ‘post-modern’ vision of human rights de-emphasized the protection of basic individual freedoms, while expanding global regulation. A strong moral and political challenge to classical human rights has emerged in the form of Eurasianism, a statist doctrine that denies the existence of universal human rights and insists that each culture has its own values. The idea of human rights as protections for basic freedoms, diluted and weakened over decades by assaults and compromises, may lack the moral clarity needed to confront the Eurasian challenge.

Construct: The impact of using nonbinary checklists for scoring residents from different levels of training participating in objective structured clinical examination (OSCE) progress tests was explored.OSCE progress tests typically employ similar rating instruments as traditional OSCEs. However, progress tests differ from other assessment modalities because learners from different stages of training participate in the same examination, which can pose challenges when deciding how to assign scores. In an attempt to better capture performance, nonbinary checklists were introduced in two OSCE progress tests. The purposes of this study were (a) to identify differences in the use of checklist options (e.g., done satisfactorily, attempted, or not done) by task type, (b) to analyze the impact of different scoring methods using nonbinary checklists for two OSCE progress tests (nonprocedural and procedural) for Internal Medicine residents, and (c) to determine which scoring method is better suited for a given task.A retrospective analysis examined differences in scores (n = 119) for two OSCE progress tests (procedural and nonprocedural). Scoring methods (hawk, dove, and hybrid) varied in stringency in how they awarded marks for nonbinary checklist items that were rated as done satisfactorily, attempted, or not done. Difficulty, reliability (internal consistency), item-total correlations and pass rates were compared for each OSCE using the three scoring methods.Mean OSCE scores were highest using the dove method and lowest using the hawk method. The hawk method resulted in higher item-total correlations for most stations, but there were differences by task type. Overall score reliability calculated using the three methods did not differ significantly. Pass-fail status differed as a function of scoring methods and exam type, with the hawk and hybrid methods resulting in higher failure rates for the nonprocedural OSCE and the dove method resulting in a higher failure rate for the procedural OSCE.The use of different scoring methods for nonbinary OSCE checklists resulted in differences in mean scores and pass-fail status. The results varied with procedural and nonprocedural OSCEs.

Construct: Valid score interpretation is important for constructs in performance assessments such as objective structured clinical examinations (OSCEs). An OSCE is a type of performance assessment in which a series of standardized patients interact with the student or candidate who is scored by either the standardized patient or a physician examiner.In high-stakes examinations, test security is an important issue. Students accessing unauthorized test materials can create an unfair advantage and lead to examination scores that do not reflect students' true ability level. The purpose of this study was to assess the impact of various simulated security breaches on OSCE scores.Seventy-six 3rd-year medical students participated in an 8-station OSCE and were randomized to either a control group or to 1 of 2 experimental conditions simulating test security breaches: station topic (i.e., providing a list of station topics prior to the examination) or egregious security breach (i.e., providing detailed content information prior to the examination). Overall total scores were compared for the 3 groups using both a one-way between-subjects analysis of variance and a repeated measure analysis of variance to compare the checklist, rating scales, and oral question subscores across the three conditions.Overall total scores were highest for the egregious security breach condition (81.8%), followed by the station topic condition (73.6%), and they were lowest for the control group (67.4%). This trend was also found with checklist subscores only (79.1%, 64.9%, and 60.3%, respectively for the security breach, station topic, and control conditions). Rating scale subscores were higher for both the station topic and egregious security breach conditions compared to the control group (82.6%, 83.1%, and 77.6%, respectively). Oral question subscores were significantly higher for the egregious security breach condition (88.8%) followed by the station topic condition (64.3%), and they were the lowest for the control group (48.6%).This simulation of different OSCE security breaches demonstrated that student performance is greatly advantaged by having prior access to test materials. This has important implications for medical educators as they develop policies and procedures regarding the safeguarding and reuse of test content.

With the growing importance of international institutions for global governance, international bureaucracies gain increasing influence on policy-making. Whereas for national bureaucracies specific administrative styles have been identified, this contribution explores for the first time administrative styles of two international organizations. The European Union (EU) Commission and the Organization for Security and Co-operation in Europe (OSCE) represent most different cases in matters of scope, autonomy and resources. The analysis of their specific patterns of policy initiation, policy formulation and policy implementation reveals striking similarities. Both organizations have developed an entrepreneurial style in policy initiation, a strategic approach to policy formulation and a mediating implementation style. These similarities lead to a paradox of weakness in the case of the OSCE and a paradox of strength in the case of the EU. These paradoxes can be understood by taking a closer look at the s...

Background: Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback. How often students choose to review this data and how review impacts future performance has not been documented. Objective: We suspect student review of F-OSCE performance data is variable. We hypothesize that students who review this data have better performance on subsequent F-OSCEs compared to those who do not. We also suspect that frequency of data review can be improved with faculty involvement in the form of student-faculty debriefing meetings. Design: Simulation recording software tracks and time stamps student review of performance data. We investigated a cohort of first- and second-year medical students from the 2015-16 academic year. Basic descriptive statistics were used to characterize frequency of data review and a linear mixed-model analysis was used to determine relationships between data review and future F-OSCE performance. Results: Students reviewed scores (64%), checklists (42%), and videos (28%) in decreasing frequency. Frequency of review of all metric and modalities improved when student-faculty debriefing meetings were conducted (p

Dear Editor I read with great interest Hopwood et al.’s ‘twelve tips for conducting a virtual OSCE’ (Hopwood et al. 2020). I am a final-year medical student, recently returned to the wards after th...

Dear Editor COVID-19 has created an urgent need to deliver assessments online. For the Objective Structured Clinical Examination (OSCE), the transition to a virtual format requires implementation o...

Dear Editor As medical students who have experienced weighted OSCE style assessments, we read Homer et al.’s (2020) article with great interest. The differences between weighted and dichotomous che...

The sequential objective structured clinical exam (OSCE) is a stand-alone variation of the traditional OSCE whereby all students sit a screening test. Those who pass this initial assessment undergo no further testing while weakly performing students sit an additional (sequential) test to determine their overall pass/fail status. Our aim was to determine outcomes of adopting a sequential OSCE approach using different numbers of screening stations and pass marks.We carried out a retrospective, observational study of anonymised databases of two cohorts of student outcomes from the final OSCE examination at the University of Aberdeen Medical School. Data were accessed for students (n = 388) who sat the exam in the years 2013-2014. We used Stata simulate program to compare outcomes - in terms of sensitivity and specificity - across 5000 random selections of 6-14 OSCE stations using random selections of groups of 100 students (with different screening test pass marks) versus those obtained across 15 stations.Across 6-14 stations, the sensitivity was ≥87% in 2013 and ≥84% in 2014 while the specificity ranged from 60% to 100% in both years. Specificity generally increased as the number of screening stations increased (with concomitant narrowing of the 95% confidence interval), while sensitivity varied between 84 and 98%. Similar sensitivities and specificities were found with screening pass marks of +1, +2 and +3 standard errors of measurement (SEM). Eight stations as a screening test appeared to be a reasonable compromise in terms of high sensitivity (88-89%) and specificity (83-86%).This research extends current sequential OSCE literature using a novel and robust approach to identify the "ideal" in terms of number of screening stations and pass mark. We discuss the educational and resource implications of our findings and make recommendations for the use of the sequential OSCE in medical education.

Patient feedback is increasingly important in clinical practice, and this should include children's views. 28 children aged 8-10 years participating in a large-scale OSCE underwent cranial nerve examination by student candidates. They scored each out of 10 for the question: 'If you had to see a doctor again, how happy would you be to see this one?' An age-adapted qualitative focus group methodology was used to explore why they scored some students more highly than others.Children's scores for the 256 medical students ranged from 2 to 10 (median 9; mean 8.46). 76% of scores were above 8. 'Good' doctor attributes included: 'friendly', 'funny', 'knowledgeable', 'confident'; 'bad' doctor attributes were: 'making mistakes', 'not paying attention', 'forgot everything', 'serious'. Children's reasons for specific scores are further explored.Scores were positively skewed, in line with most patient/simulated patient feedback, and children discriminated between candidates. It should not be assumed that clinician examiners can accurately represent the views of child patients who may value different qualities in doctors. Children participating in our study had clear views of what they want from a doctor: a consultative approach with clear and kind explanation of the process of examination.

In 2015, the OSCE will commemorate two seminal dates: the 40th anniversary of the Helsinki Final Act and the 25th anniversary of the Charter of Paris for a new Europe. This study takes these seminal dates for the OSCE as well as the current dramatic Ukrainian crisis as starting points to analyze three questions: How has Russia's relationship and role with/within the OSCE evolved throughout the years? Which role has the OSCE been playing in European security governance? How does the Ukrainian crisis affect Russia's OSCE policy and what does it mean for the OSCE? Studying Russia's OSCE policy is key to understand the OSCE's role as a framework for security governance in Europe with both its successes and failures. In order to answer these research questions, this study uses insights from (regional) security governance literature.

To compare the effect of student examiners (SE) to that of faculty examiners (FE) on examinee performance in an OSCE as well as on post-assessment evaluation in the area of emergency medicine management.An OSCE test-format (seven stations: Advanced Cardiac Life Support (ACLS), Basic Life Support (BLS), Trauma-Management (TM), Pediatric-Emergencies (PE), Acute-Coronary-Syndrome (ACS), Airway-Management (AM), and Obstetrical-Emergencies (OE)) was administered to 207 medical students in their third year of training after they had received didactics in emergency medicine management. Participants were randomly assigned to one of the two simultaneously run tracks: either with SE (n = 110) or with FE (n = 98). Students were asked to rate each OSCE station and to provide their overall OSCE perception by means of a standardized questionnaire. The independent samples t-test was used and effect sizes were calculated (Cohens d).Students achieved significantly higher scores for the OSCE stations "TM", "AM", and "OE" as well as "overall OSCE score" in the SE track, whereas the station score for "PE" was significantly higher for students in the FE track. Mostly small effect sizes were reported. In the post-assessment evaluation portion of the study, students gave significant higher ratings for the ACS station and "overall OSCE evaluation" in the FE track; also with small effect sizes.It seems quite admissible and justified to encourage medical students to officiate as examiners in undergraduate emergency medicine OSCE formative testing, but not necessarily in summative assessment evaluations.

Background: Past research suggests that the use of externally-applied scoring weights may not appreciably impact measurement qualities such as reliability or validity. Nonetheless, some credentialing boards and academic institutions apply differential scoring weights based on expert opinion about the relative importance of individual items or test components of Observed Structured Clinical Examinations (OSCEs). Aims: To investigate the impact of simplified scoring models that make little to no use of differential weighting on the reliability of scores and decisions on a high stakes OSCE required for medical licensure in Canada. Method: We applied four different weighting models of various complexities to data from three administrations of the OSCE. We compared score reliability, pass/fail rates, correlations between the scores and classification decision accuracy and consistency across the models and administrations. Results: Less complex weighting models yielded similar reliability and pass rates as the more complex weighting model. Minimal changes in candidates’ pass/fail status were observed and there were strong and statistically significant correlations between the scores for all scoring models and administrations. Classification decision accuracy and consistency were very high and similar across the four scoring models. Conclusions: Adopting a simplified weighting scheme for this OSCE did not diminish its measurement qualities. Instead of developing complex weighting schemes, experts’ time and effort could be better spent on other critical test development and assembly tasks with little to no compromise in the quality of scores and decisions on this high-stakes OSCE.

It is not uncommon for medical students to raise concerns over the difficulty of a single station within an Objective Structured Clinical Examination (OSCE), particularly when they feel they were subject to an unfair situation. Indeed, test developers also share these concerns about the possibility that a single extremely difficult station may impact student performance on the station that follows. As a reaction to the concerns of both students and examiners, we conducted a study, analyzing the scores of multiple OSCEs. Although our analyses did not support the complaints of unfairness targeted at the OSCE, we feel it is a rather enlightening story nevertheless, and one worth sharing.

Dear EditorI read with interest the article by Wood and Pugh (2019) comparing rating scales and checklists as tools of measuring increasing levels of expertise in an OSCE setting. I commend the aut...

Dear EditorWe read with great interest the article by Conway et al. [1] on devising an OSCE station around learning disabilities. We highly commend their motives and believe that it is helpful for ...

© 2013 Informa UK Ltd., Background: The Objective Structured Clinical Examination (OSCE) was introduced by Harden et al. (1975) trying to answer the problems regarding the assessment of clinical competencies. Despite increasingly widespread use of OSCEs, debate continues with arguments as ‘why using such a demanding format if other methods are available?’ Aim: To review and synthesize evidence on technical and economic feasibility of OSCE in undergraduate medical studies. Methods: Best Evidence Medical Education methodology was applied by two independent coders to 1083 studies identified by literature search from 1975 until the end of 2008. Key findings: The OSCE is a feasible approach to the assessment of clinical competence for use in different cultural and geographical contexts; to assess a wide range of learning outcomes; in different specialties and disciplines; for formative and summative purposes; to assess students a curriculum or an educational intervention; in the different phases of education including the early and later years of the undergraduate curriculum; and in different health care professions. Conclusion: Despite being an expensive test format, evidence suggests that the use of OSCE produces reliable results. The study also suggests that one reason for the wide-scale adoption of the OSCE and the feasibility of its use in different contexts and situations is its inherent flexibility in terms of the number of students that can be assessed, the number of examiners included, the type of patients represented and the format of the examination itself, including the length of the examination, the number and duration of stations.

This essay explores Russia's Organization for Security and Co-operation in Europe (OSCE) policy, by focusing on two questions. First of all, analysts have noted Russia's disinterest and obstructive policies towards the Organization. Thus, the question is what – if anything – does the Russian Federation still want from the OSCE? Secondly, does the OSCE still serve as a forum for dialog? These two issues are studied on the basis of rational institutionalism and realism. The essay demonstrates that Russia is still interested in the OSCE, but its policy has become more pragmatic, selective and instrumentalist. It includes obstructive and constructive strategies. At the same time, today the Russian Federation ascribes less significance to the Organization in European security. This is predetermined not only by its inability to push its interests through the OSCE, but also by the declining interest of other participating States in the Organization. The differences between OSCE participants have turned ...

The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence.This study used observational design whereby nursing students' clinical skills were observed and scored in five OSCE stations. Two instruments were used for the data collection - A self-administered questionnaire on the students' bio-demographic data, and a check list on the clinical skills which the examiners rated on a four point scale.The findings revealed that 14% of the nurses had level four competence, which indicated that they could perform the tasks correctly and complete. However, 12% failed the OSCE, even though they had more than 10 years experience in nursing and post basic qualifications. Inter-rater reliability was 0.92 for the five examiners. Factor analysis indicated that five participant factors accounted for 74.1% of the variations in clinical skills performance.An OSCE is a necessary assessment tool that should be continuously applied in nursing education, regardless of the mode of the education program, the student's years of experience or his/her clinical placement. This study validates the need for OSCE in both the design of tertiary nursing degree programs and the assessment of nurses' clinical competency level.

Dear SirBefore this study was carried out we did introduce some changes to the differing days, e.g. by changing patients or X-rays for example but a balance is required between reducing the impact ...

Dear SirAlthough rapport, safety and professionalism are assessed to some extent and we are looking to improve on this in the future, these aspects alone are not enough to pass a station. Students ...