Objective Structured Clinical Examination
An Objective Structured Clinical Examination (OSCE) is a modern type of examination often used in medicine to test skills such as communication, clinical examination, medical procedures, prescribing and interpretation of results.
It has also been used to assess clinical skills performance in non medical prescribers as well as nursing.
It normally consists of several short (5-10 minute) stations and each is examined on a one-to-one basis with either real or simulated patients (actors). It is considered to be an improvement over traditional examination methods because the stations can be standardised enabling fairer peer comparison and complex procedures can be assessed without endangering patients health.
One of the way OSCE's are made objective is to have a detailed mark scheme and standard set of questions. For example a station concerning the demonstration to a simulated patient on how to use a Metered dose inhaler [MDI] the mark scheme would mark specific points. (i.e. candidate explains to patient the need for a seal around the mouthpiece etc.)
There are however criticisms that the OSCE stations can never be truly standardised and objective in the same way a written MCQ can. It has been known for different examiners to afford more assistance and for different marking criteria to be applied - especially where different Base Hospital sites are involved.
Finally - it is not uncommon at certain institutions for members of teaching staff known to students and vice versa to asses students. This need not affect the integrity of the examination process although there is a deviation from anonymous marking.
Preparing for OSCEs is very different to preparing for a theory examination. What is being tested is skills rather than pure theoretical knowledge.
It is essential to learn correct clinical methods and then practice repeatedly until one perfects the methods.
Marks are awarded for each step in the method hence it is essential to dissect the method into its individual steps, learn the steps and then learn to perform the steps in a sequence.
- Assessment of clinical competence using objective structured examination, Harden et al., Br Med J. 1975 Feb 22;1(5955):447-51
- (Ross, M., Carroll, G., Knight, J., Chamberlain, M., Fothergill-Bourbonnais, F., and Linton, J. (1988) Using the OSCE to measure clinical skills performance in nursing. Journal of Advanced Nursing, 13, 45-56).