O'Leary Fenton
Emergency Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Emerg Med Australas. 2015 Apr;27(2):173-5. doi: 10.1111/1742-6723.12370. Epub 2015 Feb 17.
The Australasian College for Emergency Medicine (ACEM) will introduce high stakes simulation-based summative assessment in the form of Objective Structured Clinical Examinations (OSCEs) into the Fellowship Examination from 2015. Miller's model emphasises that, no matter how realistic the simulation, it is still a simulation and examinees do not necessarily behave as in real life. OSCEs are suitable for assessing the CanMEDS domains of Medical Expert, Communicator, Collaborator and Manager. However, the need to validate the OSCE is emphasised by conflicting evidence on correlation with long-term faculty assessments, between essential actions checklists and global assessment scores and variable interrater reliability within individual OSCE stations and for crisis resource management skills. Although OSCEs can be a valid, reliable and acceptable assessment tool, the onus is on the examining body to ensure construct validity and high interrater reliability.
澳大利亚急诊医学学院（ACEM）将于2015年起在专科医师考试中引入基于高风险模拟的终结性评估，采用客观结构化临床考试（OSCE）的形式。米勒模型强调，无论模拟多么逼真，它仍然只是模拟，考生的表现不一定与现实生活中一样。OSCE适用于评估医学专家、沟通者、协作者和管理者等CanMEDS领域。然而，关于与长期教员评估的相关性、基本操作清单与整体评估分数之间的关系以及各个OSCE站点内评分者间信度的变化以及危机资源管理技能方面，相互矛盾的证据凸显了验证OSCE的必要性。尽管OSCE可以是一种有效、可靠且可接受的评估工具，但审查机构有责任确保结构效度和高评分者间信度。
