Despite concerted efforts to create standardized, objective, competency-based evaluations, the assessment of residents' clinical performance still has a strong subjective influence. Attendings' holistic impressions should not be considered invalid simply because they are subjective. Instead, assessment methods should consider novel ways of accommodating these impressions to improve evaluation.
In this study, a summated analytic global rating demonstrated construct validity, as did 2 of the 4 scales measuring specific traits. In addition, the analytic global rating showed substantially higher internal consistency than did the checklists, a finding consistent with that seen in previous studies cited in the literature. Global ratings are an important element of OSCE measurement and can have good psychometric properties. However, OSCE researchers should clearly describe the type of global ratings they use. Further research is needed to define the most effective global rating scales.
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