Pascual Ramos Virginia, Medrano Ramírez Gabriel, Solís Vallejo Eunice, Bernard Medina Ana Guilaisne, Flores Alvarado Diana Elsa, Portela Hernández Margarita, Andrade Ortega Lilia, Vera Lastra Olga, Espinosa Morales Rolando, Miranda Limón Juan Manuel, Maldonado Velázquez María Del Rocío, Jara Quezada Luis Javier, Amezcua Guerra Luis Manuel, López Zepeda Judith, Saavedra Salinas Miguel Ángel, Arce Salinas Cesar Alejandro
Consejo Mexicano de Reumatología, México DF, México.
Consejo Mexicano de Reumatología, México DF, México.
Reumatol Clin. 2015 Jul-Aug;11(4):215-20. doi: 10.1016/j.reuma.2014.10.007. Epub 2014 Dec 15.
To assess reliability and validity of the objectively-structured clinical examination (OSCE) applied in postgraduate certification processes by the Mexican Board of Rheumatology.
Thirty-two (2013) and 38 (2014) Rheumatology trainees (RTs) underwent an OSCE consisting of 12 and 15 stations respectively, scored according to a validated check-list, as well as 300-multiple-choice 300 question examination (MCQ). Previously, 3 certified rheumatologists underwent a pilot-OSCE. A composite OSCE score was obtained for each participant and its performance examined.
In 2013, OSCE mean score was 7.1±0.6 with none RT receiving a failing score while the MCQ score was 6.5±0.6 and 7 (21.9%) RTs receiving a failing (< 6) score. In 2014, the OSCE score was 6.7±0.6, with 3 (7.9%) RTs receiving a failing score (2 of them also failed MCQ) while the MCQ score was 6.4±0.5 and 7 (18.5%) RTs were disqualified (2 of them also failed OSCE). A significant correlation between the MCQ and the OSCE scores was observed in the 2013 (r=0.44; P=0.006). Certified rheumatologists performed better than RTs at both OSCE. Overall, 86% of RTs obtaining an OSCE passing score also obtained a MCQ passing score, while this was only 67% (P=.02) among those who obtained an OSCE failing score. Nine stations were applied at both consecutive years. Their performance was similar in both certification processes, with correlation coefficients ranging from 0.81 to 0.95 (P≤0.01).
The OSCE is a valid and reliable tool to assess the Rheumatology clinical skills in RTs.
评估墨西哥风湿病委员会在研究生认证过程中应用的客观结构化临床考试（OSCE）的可靠性和有效性。
32名（2013年）和38名（2014年）风湿病学员分别参加了由12个和15个站点组成的OSCE，根据经过验证的检查表进行评分，同时还参加了300道多项选择题考试（MCQ）。此前，3名认证风湿病专家参加了OSCE预测试。为每位参与者获得综合OSCE分数并检查其表现。
2013年，OSCE平均分数为7.1±0.6，没有学员不及格，而MCQ分数为6.5±0.6，7名（21.9%）学员不及格（<6分）。2014年，OSCE分数为6.7±0.6，3名（7.9%）学员不及格（其中2人MCQ也不及格），而MCQ分数为6.4±0.5，7名（18.5%）学员不合格（其中2人OSCE也不及格）。2013年观察到MCQ和OSCE分数之间存在显著相关性（r=0.44；P=0.006）。认证风湿病专家在两个OSCE中的表现均优于学员。总体而言，86%获得OSCE及格分数的学员也获得了MCQ及格分数，而在获得OSCE不及格分数的学员中，这一比例仅为67%（P=0.02）。连续两年应用了9个站点。它们在两个认证过程中的表现相似，相关系数在0.81至0.95之间（P≤0.01）。
OSCE是评估风湿病学员临床技能的有效且可靠的工具。
