Examination of Clinical Examiners

Wilson, G. M.; Lever, Rosemary; Harden, Ronald M.; Robertson, J. I. S.; MacRitchie, John

doi:10.1016/s0140-6736(69)90998-2

Cited by 61 publications

(39 citation statements)

References 10 publications

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“…Even though they are intended to be structured and objective, the judgments are still made by individual teachers/evaluators whose assessments criteria might jeopardize both reliability and validity (Weatherall 1991;Wilson et al 1969). …”

Section: Objective Structured Clinical Examinationmentioning

confidence: 99%

The use of a virtual patient case in an OSCE-based exam – A pilot study

et al. 2008

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Background: This study focuses on a skills test based clinical assessment where 118 fourth-year medical students at the four teaching hospitals of Karolinska Institutet participated in the same 12-module OSCE. The goal of one of the twelve examination modules was to assess the students' skills and ability to solve a virtual patient (VP) case (the ISP system), which included medical history taking, lab tests, physical examinations and suggestion of a preliminary diagnosis. Aims: The primary aim of this study was to evaluate the potential of a VP as a possible tool for assessment of clinical reasoning and problem solving ability among medical students. The feeling of realism of the VP and its possible affective impact on the student's confidence were also investigated. Method: We observed and analysed students' reactions, engagement and performance (activity log files) during their interactive sessions with the simulation. An individual human assistant was provided along with the computer simulation and the videotaped interaction student/assistant was then analysed in detail and related to the students' outcomes. Results:The results indicate possible advantages of using ISP-like systems for assessment. The VP was for instance able to reliably differentiate between students' performances but some weaknesses were also identified, like a confounding influence on students' outcomes by the assistants used. Significant differences, affecting the results, were found between the students in their degree of affective response towards the system as well as the perceived usefulness of assistance. Conclusion: Students need to be trained beforehand in mastering the assessment tool. Rating compliance needs to be targeted before VP-based systems like ISP can be used in exams and if such systems would be used in high-stake exams, the use of human assistants should be limited and scoring rubrics validated (and preferably automated).

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Section: Objective Structured Clinical Examinationmentioning

confidence: 99%

The use of a virtual patient case in an OSCE-based exam – A pilot study

et al. 2008

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“…Some experts considered any diagnosis that included a bacterial etiology correct whereas others were extremely stringent and only considered those diagnoses that definitively stated the known correct diagnosis without any expression of doubt. This type of disagreement in expert ratings has been documented and discussed extensively (Wilson et al 1969;Herbers et al 1989;Colliver et al 1991;Pitts et al 1999;Miller 2002). The findings presented here suggest that this inconsistency is not related to expert knowledge organization but is instead related to how experts parse that knowledge when making value judgments.…”

Section: Discussionmentioning

confidence: 50%

“…An expert may use some or all of these criteria, weighted in an idiosyncratic manner, to determine whether an individual diagnosis is right or wrong. Medical experts and raters can vary tremendously in their conceptual organization and on their assessment of student performance (Wilson et al 1969;Grant and Marsden 1987;Herbers et al 1989;Colliver et al 1991;McGaghie et al 1994;Pitts et al 1999).…”

Section: Introductionmentioning

confidence: 99%

Defining the correctness of a diagnosis: differential judgments and expert knowledge

Kanter

Brosenitsch

Mahoney

et al. 2010

Adv in Health Sci Educ

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Approaches that use a simulated patient case to study and assess diagnostic reasoning usually use the correct diagnosis of the case as a measure of success and as an anchor for other measures. Commonly, the correctness of a diagnosis is determined by the judgment of one or more experts. In this study, the consistency of experts' judgments of the correctness of a diagnosis, and the structure of knowledge supporting their judgments, were explored using a card sorting task. Seven expert pediatricians were asked to sort into piles the diagnoses proposed by 119 individuals who had worked through a simulated patient case of Haemophilus influenzae Type B (HIB) meningitis. The 119 individuals had varying experience levels. The expert pediatricians were asked to sort the proposed diagnoses by similarity of content, and then to order the piles based on correctness, relative to the known correct diagnosis (HIB meningitis). Finally, the experts were asked to judge which piles contained correct or incorrect diagnoses. We found that, contrary to previous studies, experts shared a common conceptual framework of the diagnostic domain being considered and were consistent in how they categorized the diagnoses. However, similar to previous studies, the experts differed greatly in their judgment of which diagnoses were correct. This study has important implications for understanding expert knowledge, for scoring performance on simulated or real patient cases, for providing feedback to learners in the clinical setting, and for establishing criteria that define what is correct in studies of diagnostic error and diagnostic reasoning.

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“…Examiner variation: it has been shown that the marks awarded by different examiners can vary for the same performance 2 . Similarly the same examiner may award different marks for the same performance on different occasions!…”

Section: Disadvantages Of the Conventional Clinical Examinationmentioning

confidence: 99%

The OSCE

Senanayake

2009

Sri Lanka J Child Health

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Examination of Clinical Examiners

Cited by 61 publications

References 10 publications

The use of a virtual patient case in an OSCE-based exam – A pilot study

The use of a virtual patient case in an OSCE-based exam – A pilot study

Defining the correctness of a diagnosis: differential judgments and expert knowledge

The OSCE

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