Chong Lauren, Taylor Silas, Haywood Matthew, Adelstein Barbara-Ann, Shulruf Boaz
Clinical Skills Teaching Unit, Prince of Wales Hospital, Sydney, Australia.
Office of Medical Education, University of New South Wales, Sydney, Australia.
J Educ Eval Health Prof. 2017 Dec 27;14:34. doi: 10.3352/jeehp.2017.14.34. eCollection 2017.
The objective structured clinical examination (OSCE) is considered to be one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners' assessment scores are influenced by several factors that may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners' assessments.
We performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed, with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area.
OSCE examiners' assessment scores are influenced by factors belonging to 4 different domains: examination context, examinee characteristics, examinee-examiner interactions, and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects; the examiner's gender and ethnicity; training; lifetime experience in assessing; leadership and familiarity with students; station type; and site effects.
Several factors may influence the presumed objectivity of examiners' assessments, and these factors need to be addressed to ensure the objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.
客观结构化临床考试（OSCE）被认为是临床评估最可靠的方法之一。其优势之一在于，由于为每位考生的考试项目和任务进行了标准化，它能够最大程度地减少考官偏见的影响。然而，OSCE考官的评估分数受到若干因素的影响，这些因素可能会损害OSCE假定的客观性。为了更好地理解这一现象，本综述旨在确定并描述考官偏见的重要来源以及影响考官评估的因素。
我们使用Medline对医学文献进行了叙述性综述。对所有符合入选标准的文章进行了审查，提取了要点并综合成该领域知识的清晰全面的总结。
OSCE考官的评估分数受到属于4个不同领域的因素影响：考试环境、考生特征、考生与考官的互动以及考官特征。这些领域由若干因素组成，包括光环效应、鹰派/鸽派效应和OSCE对比效应；考官的性别和种族；培训；评估方面的终身经验；领导能力以及对学生的熟悉程度；考站类型；以及场地效应。
若干因素可能会影响考官评估假定的客观性，需要解决这些因素以确保OSCE的客观性。我们为未来的研究方向提供了见解以便更好地理解和解决考官偏见现象。
