Table of Contents
Foreword v
Acknowledgments ix
Preface xi
Chapter 1 The Birth and Propagation of the OSCE 1
The Birth 2
OSCE as a Global Phenomenon 6
Summary 7
References 8
Chapter 2 The OSCE in the Context of a Holistic Assessment 9
How Docs the OSCE Fit into Overall Assessment? 10
Basic Configuration of an OSCE 12
Why is an OSCE Preferable Over Traditional Clinical Examinations? 15
OSCE, Short Cases, and the Mini-CEX 18
OSCE Pretenders or Imitation OSCEs 19
Summary 21
References 21
Chapter 3 Value of the OSCE as an Assessment Tool 23
Validity 24
Reliability 27
Educational Impact 30
Acceptability 33
Cost 34
Summary 34
References 35
Chapter 4 Selecting the Skills to be Tested in an OSCE through Blueprinting 37
Basic Concepts of Blueprinting 38
Master Blueprint 40
OSCE Blueprint 44
Further Specifications 51
Summary 54
References 54
Chapter 5 Utilizing Different Formats of OSCE for Greater Efficiency 55
Formative and Summative OSCEs 55
Active and Static Stations 55
Couplet or Linked Stations 58
Long-Station OSCEs 59
Objective Structured Practical Examination 60
Summary 52
References 53
Chapter 6 Writing OSCE Stations 65
Forming the Team to Write the OSCE Station 65
Developing Instructions to the Candidate 66
Developing Instructions to the Simulated and Standardized Patients 68
Developing Instructions to the Examiners 71
Preparing Equipment and Materials 73
Summary 76
References 76
Chapter 7 Creating a Scoring Template for Assigning Marks 77
Purpose of a Scoring Template 78
Different Formats of Itemized Checklists 78
Qualitative Comments 84
Generic Marking Template 85
Global Rating 87
Summary 90
References 91
Chapter 8 Preparing Patients for the OSCE 93
Balance between Standardization and Authenticity 95
Degree of Realism as Portrayed by the Patients 96
Nature of Tasks to be Tested 98
Purpose of the OSCE 99
Logistics and Practical Considerations 100
Preparing Real Patients for the OSCE 100
Recruiting and Training Simulated Patients for the OSCE 104
Summary 106
References 106
Chapter 9 Preparing Simulators for the OSCE 109
Simulators and Simulation in Medical Education 110
Range of Simulators and Simulation 112
Skills that can be Tested in the OSCE with Simulators 113
Summary 118
References 119
Chapter 10 Preparing the Groundwork for Conducting an OSCE 121
Faculty Training 121
Selecting Examiners for an OSCE 123
Examiners' Briefing 125
Students' Briefing 127
Pilot Run 127
Checklist for the Day of the OSCE 129
OSCE Administration 130
Security 130
Summary 132
References 132
Chapter 11 Determining Passes and Fails in an OSCE 133
Basic Concepts and Principles of Standard Setting 133
Classical Borderline Group Method of Standard Setting 137
Borderline Regression Method 140
Summary 742
References 142
Chapter 12 Post-Assessment Quality Assurance 143
Quantitative Data (Item Analysis) 144
Qualitative Data (Feedback) 154
Utilization of Data 155
Summary 155
References 157
Chapter 13 Feedback, Moderation, and Banking 159
Feedback to the Curriculum Committee 159
Feedback to the Candidate 160
Moderation of Marks 161
Banking of OSCE Stations 162
Summary 164
References 164
Chapter 14 Helping Poorly Performing Students in an OSCE 165
Importance of Remediation 165
Reasons for Poor Performance in an OSCE 166
Customization of Remediation Strategies 169
Challenges in Remediation 174
Summary 174
References 175
Chapter 15 OSCE as a Tool for the Selection of Applicants 177
The Flexibility of the OSCE Format 177
How to Develop a Selection OSCE 179
Evaluating the Utility of the Selection OSCE 182
Strengths and Limitations of the Selection OSCE 183
Summary 183
References 184
Appendix 15.1 An Example of a Selection OSCE Station 185
Instructions to the Candidate 185
Instructions to the Simulated Friend 185
Instructions to the Examiner 186
List of Equipment 188
Chapter 16 Frequently Asked Questions about the OSCE 189
What is the Optimum Number of Stations in an OSCE? 189
What Should be the Length of Each Station? 189
Should there be Two Examiners per Station or One Examiner per Station? 190
Can We have an OSCE with Variable Durations of Stations? 190
Do We Need to have a Rest Station in an OSCE? 191
Do We Need Expert Examiners for an OSCE? 191
Can We Include Non-Physicians as OSCE Examiners? 191
Should the Patient Mark the OSCE Station? 192
Should the Examiners Provide Feedback to the Candidate during the OSCB? 192
Should the Examiners Ask Questions of the Candidate during the OSCE? 192
Can We have Real Patients in an OSCE? 193
Can We Use Clinical Photographs in an OSCE? 193
Should there be Any "Killer" Stations in an OSCE? 193
Can We have Two OSCE Stations that are Linked Together? 194
Which One of the Two Marking Methods, Checklist or Rating, is Superior? 194
How Many Items Should a Checklist Contain? 195
How Can We Determine the Pass/Fail Mark of the OSCE? 195
How Do We Maintain Examination Security when there arc Multiple Sessions? 195
How Should We Select a Venue for the OSCE? 196
How Can We Run an OSCE Over Two Days? 196
Can We Videotape OSCE Stations? 197
How Much Time do We Need to Prepare for an OSCE? 197
Index 199
Authors' Biographies 203
