Muthusami Anitha, Mohsina Subair, Sureshkumar Sathasivam, Anandhi Amaranathan, Elamurugan Thirthar Palanivelu, Srinivasan Krishnamachari, Mahalakshmy Thulasingam, Kate Vikram
Department of Surgery, Pondicherry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
J Surg Educ. 2017 May-Jun;74(3):398-405. doi: 10.1016/j.jsurg.2016.11.004. Epub 2016 Nov 29.
Traditionally assessment in medical training programs has been through subjective faculty evaluations or multiple choice questions. Conventional examinations provide assessment of the global performance rather than individual competencies thus making the final feedback less meaningful. The objective structured clinical examination (OSCE) is a relatively new multidimensional tool for evaluating training. This study was carried out to determine the efficacy and feasibility of OSCE as a tool for the internal assessment of surgery residents.
This study was carried out on the marks obtained by surgery residents at different levels of training in a single tertiary center in India over the 4 OSCEs conducted in the years 2015 and 2016. The marks of the OSCE were collected from the departmental records and analyzed. Reliability was calculated using internal consistency using Cronbach's α. Validity was calculated by item total correlation. Content validation was done by obtaining expert reviews from 5 experts using a proforma, to assess the content and checklist of each station of the OSCE.
A total of 49 surgery residents were assessed in small batches during the above mentioned period. Of the 4 OSCEs conducted by us, 3 had a high value of Cronbach's α of greater than 0.9, as opposed to the set standard of 0.7. Out of 23 stations used in the 4 examinations separately, only 3 stations were found to have a low correlation coefficient (item total correlation), and hence, a low validity. The remaining 20 stations were found to have a high validity. Expert review showed unanimous validation of the content of 17 out of the 23 stations, with few suggestions for change in the remaining 6 stations. The material and manpower used was minimal and easy to obtain, thus making the OSCE feasible to conduct.
OSCE is a reliable, valid. and feasible method for evaluating surgery residents at various levels of training.
传统上，医学培训项目的评估方式是主观的教员评价或多项选择题。传统考试评估的是整体表现而非个人能力，因此最终反馈的意义不大。客观结构化临床考试（OSCE）是一种相对较新的用于评估培训的多维度工具。本研究旨在确定OSCE作为外科住院医师内部评估工具的有效性和可行性。
本研究基于印度一家三级中心在2015年和2016年进行的4次OSCE中不同培训阶段外科住院医师获得的分数展开。OSCE的分数从部门记录中收集并进行分析。使用Cronbach's α计算内部一致性来评估信度。通过项目总分相关性计算效度。通过使用一份表格从5位专家那里获得专家评审意见来进行内容效度验证，以评估OSCE每个站点的内容和检查表。
在上述期间，共分小批次对49名外科住院医师进行了评估。我们进行的4次OSCE中，有3次的Cronbach's α值高于设定标准0.7，达到了大于0.9的较高水平。在4次考试分别使用的23个站点中，只有3个站点的相关系数（项目总分相关性）较低，因此效度较低。其余20个站点被发现具有较高的效度。专家评审显示，23个站点中有17个站点的内容得到一致认可，其余6个站点只需做少量修改。所使用的材料和人力极少且易于获取，因此OSCE实施起来可行。
OSCE是评估不同培训阶段外科住院医师的一种可靠、有效且可行的方法。
