The objective structured clinical examination for general practice: design, validity and reliability.

This paper describes and analyses an experimental clinical examination for general practice. Differences in the results obtained by fourth year students, fifth year students and trainee general practitioners highlight some of the dilemmas of medical education. It is concluded that examinations which include clinical tests can increase the credibility of general practice examinations, can be reliably applied to small groups of candidates and therefore have considerable potential for formative assessment. The constraints of assuring inter-examiner reliability in a multicentre design, together with its labour intensive nature, would however make this type of examination difficult to adapt to the needs of national end-of-training examinations.