Massachusetts Mental Health Center, Boston, MA 02130, USA.
Acad Psychiatry. 2010 Mar-Apr;34(2):141-4. doi: 10.1176/appi.ap.34.2.141.
The OSCE has been demonstrated to be a reliable and valid method by which to assess students' clinical skills. An OSCE station was used to determine whether or not students who had completed a core psychiatry clerkship demonstrated skills that were superior to those who had not taken the clerkship and which areas discriminated between clerkship completers and noncompleters.
One hundred thirty-six students took a 48-item, fourth-year OSCE with one psychiatry station. Sixty-three (46%) had already completed psychiatry, and 70 (51%) had not, with three unknown. Students were to take histories, perform mental status examinations, assess dangerousness, and propose the differential diagnosis and treatment plans.
Nine items differed significantly between completers and noncompleters, six concerning phenomenology and mental status and three concerning differential diagnosis. There were no differences regarding history, communication skills, or recommended interventions.
Students may learn history taking, communication, and treatment planning in many settings. However, for the mental status examination, phenomenology, and differential diagnosis, completing a psychiatry clerkship was associated with better OSCE performance.
客观结构化临床考试（OSCE）已被证明是评估学生临床技能的可靠和有效的方法。我们使用 OSCE 站来确定是否已经完成核心精神病学实习的学生表现出优于未参加实习的学生的技能，以及哪些领域可以区分实习完成者和未完成者。
136 名学生参加了一项包含一个精神病学站的第四年 48 项的 OSCE。其中 63 人（46%）已经完成了精神病学实习，70 人（51%）没有，3 人未知。学生需要采集病史、进行精神状态检查、评估危险性，并提出鉴别诊断和治疗计划。
完成者和未完成者在 9 项上存在显著差异，其中 6 项涉及症状学和精神状态，3 项涉及鉴别诊断。在病史、沟通技巧或推荐的干预措施方面没有差异。
学生可能在许多环境中学习病史采集、沟通和治疗计划。然而，对于精神状态检查、症状学和鉴别诊断，完成精神病学实习与更好的 OSCE 表现相关。
