Department of Neurology, University of Chicago, IL, USA.
Neurology. 2012 Aug 14;79(7):681-5. doi: 10.1212/WNL.0b013e3182648ba1. Epub 2012 Aug 1.
We evaluated the reliability and predictive ability of an objective structured clinical examination (OSCE) in the assessment of medical students at the completion of a neurology clerkship.
We analyzed data from 195 third-year medical students who took the OSCE. For each student, the OSCE consisted of 2 standardized patient encounters. The scores obtained from each encounter were compared. Faculty clinical evaluations of each student for 2 clinical inpatient rotations were also compared. Hierarchical regression analysis was applied to test the ability of the averaged OSCE scores to predict standardized written examination scores and composite clinical scores.
Students' OSCE scores from the 2 standardized patient encounters were significantly correlated with each other (r = 0.347, p < 0.001), and the scores for all students were normally distributed. In contrast, students' faculty clinical evaluation scores from 2 different clinical inpatient rotations were uncorrelated, and scores were skewed toward the highest ratings. After accounting for clerkship order, better OSCE scores were predictive of better National Board of Medical Examiners standardized examination scores (R(2)Δ = 0.131, p < 0.001) and of better faculty clinical scores (R(2)Δ = 0.078, p < 0.001).
Student assessment by an OSCE provides a reliable and predictive objective assessment of clinical performance in a neurology clerkship.
我们评估了客观结构化临床考试（OSCE）在评估神经病学实习结束时医学生的可靠性和预测能力。
我们分析了 195 名参加 OSCE 的三年级医学生的数据。对于每个学生，OSCE 包括 2 个标准化患者接触。比较每个接触点获得的分数。还比较了每位学生在 2 个临床住院轮次中的教师临床评估。应用层次回归分析来检验平均 OSCE 分数预测标准化书面考试分数和综合临床分数的能力。
学生在 2 个标准化患者接触中的 OSCE 分数彼此显著相关（r = 0.347，p < 0.001），并且所有学生的分数呈正态分布。相比之下，学生在 2 个不同临床住院轮次中的教师临床评估分数没有相关性，且分数向最高分倾斜。在考虑实习顺序后，更好的 OSCE 分数预测更好的国家医学考试委员会标准化考试分数（R²Δ= 0.131，p < 0.001）和更好的教师临床分数（R²Δ= 0.078，p < 0.001）。
OSCE 对学生的评估提供了神经病学实习中临床表现的可靠和预测性的客观评估。
