Monash Ageing Research Centre (MONARC), Monash University, Melbourne, VIC, Australia.
Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.
Adv Exp Med Biol. 2017;988:159-180. doi: 10.1007/978-3-319-56246-9_13.
Over the last two decades, Objective Structured Clinical Examination (OSCE) has become an increasingly important part of psychiatry education and assessment in the Australian context. A reappraisal of the evidence base regarding the use of OSCE in psychiatry is therefore timely. This paper reviews the literature regarding the use of OSCE as an assessment tool in both undergraduate and postgraduate psychiatry training settings. Suitable articles were identified using the search terms 'psychiatry AND OSCE' in the ERIC (educational) and PubMed (healthcare) databases and grouped according to their predominant focus: (1) the validity of OSCEs in psychiatry; (2) candidate preparation and other factors impacting on performance; and (3) special topics. The literature suggests that the OSCE has been widely adopted in psychiatry education, as a valid and reliable method of assessing psychiatric competencies that is acceptable to both learners and teachers alike. The limited evidence base regarding its validity for postgraduate psychiatry examinations suggests that more research is needed in this domain. Despite any shortcomings, OSCEs are currently ubiquitous in all areas of undergraduate and postgraduate medicine and proposing a better alternative for competency-based assessment is difficult. A critical question is whether OSCE is sufficient on its own to assess high-level consultancy skills, and aspects of professionalism and ethical practice, that are essential for effective specialist practice, or whether it needs to be supplemented by additional testing modalities.
在过去的二十年中，客观结构化临床考试（OSCE）已成为澳大利亚精神病学教育和评估中越来越重要的一部分。因此，及时重新评估 OSCE 在精神病学中的应用证据基础是很有必要的。本文综述了 OSCE 在本科和研究生精神病学培训环境中作为评估工具的使用情况的文献。使用 ERIC（教育）和 PubMed（医疗保健）数据库中的搜索词“psychiatry AND OSCE”来识别合适的文章，并根据其主要重点进行分组：（1）OSCE 在精神病学中的有效性；（2）候选人准备情况和影响表现的其他因素；（3）特殊主题。文献表明，OSCE 已广泛应用于精神病学教育，作为评估精神病学能力的一种有效且可靠的方法，既被学习者也被教师所接受。针对研究生精神病学考试的有效性的有限证据基础表明，这一领域需要更多的研究。尽管存在任何缺点，OSCE 目前在本科和研究生医学的所有领域都普遍存在，提出一种更好的基于能力的评估替代方案是困难的。一个关键问题是 OSCE 本身是否足以评估高级咨询技能以及专业精神和道德实践的方面，这些都是有效专家实践所必需的，或者它是否需要通过其他测试方式来补充。
