Clinical and Molecular Genetics Unit, Department of Paediatric and Adolescent Endocrinology, Institute of Child Health, Great Ormond Street Children’s Hospital, 30 Guilford Street, London, WC1N 1EH, UK.
Med Teach. 2012;34(5):404-10. doi: 10.3109/0142159X.2012.668242. Epub 2012 Apr 3.
Competency in the management of acutely unwell patients has not previously been formally assessed as part of an objective structured clinical examination (OSCE).
The reliability of the paediatric postgraduate OSCE was calculated. An objective structured video examination was designed to assess candidates' clinical decision making ability when managing acutely unwell children.
The performance of 3522 postgraduate paediatric trainees was assessed (2006-2008). OSCE reliability was determined using Cronbach's alpha and mean inter-item correlation. Performance in the video station was compared with overall performance (not including video station; Mann-Whitney U) and video station scores correlated with individual station scores (Spearman's Rho correlation coefficient).
Clinical examination pass rates for the 684 UK graduates, 1608 overseas candidates training in the UK and 1104 overseas candidates training overseas were 69.7%, 28% and 22.3%, respectively (graduation information not available for 126 candidates). Cronbach's alpha was 0.62. Mean inter-item correlation was 0.15. Candidates who passed the OSCE overall had significantly higher scores on the video station (t(3520) = 14.48); p < 0.001). There was significant positive correlation between scores on the video station, individual stations and overall total score (r's = 0.300; p = 0.001).
The postgraduate paediatric OSCE provides a sound and valid means of assessing clinical skills at the postgraduate level. The video station provides an important new method of assessment. Its use in other postgraduate clinical examinations should be explored.
以前，在客观结构化临床考试（OSCE）中并未对处理病情突然恶化的患者的能力进行正式评估。
计算儿科研究生 OSCE 的可靠性。设计了一个客观结构化视频考试，以评估候选人在管理病情突然恶化的儿童时的临床决策能力。
评估了 3522 名儿科研究生学员的表现（2006-2008 年）。使用 Cronbach's alpha 和平均项目间相关性来确定 OSCE 的可靠性。将视频站的表现与总体表现（不包括视频站；Mann-Whitney U）进行比较，并将视频站的分数与各个站的分数相关联（Spearman's Rho 相关系数）。
英国的 684 名毕业生、在英国培训的 1608 名海外考生和在海外培训的 1104 名海外考生的临床检查通过率分别为 69.7%、28%和 22.3%（126 名考生的毕业信息不可用）。Cronbach's alpha 为 0.62。平均项目间相关性为 0.15。通过 OSCE 总体考试的考生在视频站的得分显著更高（t(3520)=14.48；p<0.001）。视频站、各站和总体总分的得分之间存在显著正相关（r's=0.300；p=0.001）。
研究生儿科 OSCE 为评估研究生水平的临床技能提供了可靠有效的方法。视频站提供了一种新的重要评估方法。应探索在其他研究生临床考试中使用它。
