Designing the Objective Structured Clinical Examination to Cover All Major Areas of Physical Medicine and Rehabilitation over 3 yrs

Abstract

The Accreditation Council for Graduate Medical Education requires that training programs comprehensively evaluate residents in the six core Accreditation Council for Graduate Medical Education competencies. One of the ways we do this in our residency is by administering a nine-station Objective Structured Clinical Examination (OSCE) at the end of each year, which evaluates tasks such as history taking, focused physical examination, communication, professionalism, procedural skills, management, prescription writing, and understanding systems-based practice. We have classified our OSCE stations into what we consider key areas in our field and assessed these on a rotating basis over 3 yrs. This results in the assessment of 27 areas over the 3 yrs of residency. Structuring the OSCE as a series of stations over 3 yrs is an efficient method to evaluate residents' competencies that are required by the Accreditation Council for Graduate Medical Education and certifying boards. An analysis of OSCE scores when compared with American Board of Physical Medicine & Rehabilitation parts 1 and 2 scores and final summative resident evaluation scores reveals that OSCE results correlate with part 1 scores and final evaluation scores but do not show the same strong correlations with part 2 scores. We discuss the way the OSCE can complete other assessment techniques and ways to improve cases in the future.

Evaluating medical residents as managers of care: a critical appraisal of assessment methods

“…The OSCEs in these studies had several stations, in order to assess residents’ competencies, including the care-management competency. While Jefferies et al32 concluded in their study that “the OSCE could be useful as a reliable and valid method for simultaneously assessing multiple physician competencies”, Garstang et al29 did not find any significant correlations between ABPMR (American Board of Physical Medicine and Rehabilitation) scores and OSCE scores on the manager role. We also found two articles that described the use of global rating forms to measure residents’ general competencies including care-management 30,35.…”

“…In the majority of these studies, new assessment tools were developed or previously known ones modified for this purpose 29–32,34–36,38. Two articles evaluated self-developed oral simulated clinical examination (OSCE) 29,32. The OSCEs in these studies had several stations, in order to assess residents’ competencies, including the care-management competency.…”

Development and Initial Validation of a Project-Based Rubric to Assess the Systems-Based Practice Competency of Residents in the Clinical Chemistry Rotation of a Pathology Residency

“…Previously published evaluation methods to assess resident competency in SBP included surveys and questionnaires of self-reported improvement, 22 observation using objective structured clinical examination, 23,24 simulated cases with examinations, 25 Web-based tools, 26-28 and simulation. 29 Two prior studies 18,30 described resident projects, yet did not use validated instruments for assessment.…”