Objective structured clinical examination in a pediatric residency program
B. Joorabchi
Wayne/Oakland Child and Adolescent Medicine Program, Pontiac General Hospital, MI 48341.
This report describes and evaluates a 42-station objective structured
clinical examination (OSCE) administered to 29 pediatric residents and six
medical students. In half of the stations, residents spent 5 minutes
performing a clearly defined clinical task while being rated by an
observer. In the other half of the stations, they answered questions based
on the data just gathered. There were six interviews with real or simulated
patients, four physical examinations, six laboratory tests or procedures,
and one chart review. Eight rest stops were provided. The results of the
OSCE were compared with those of resident performance ratings and the
Pediatric Board's in-training examination. The OSCE scores could clearly
separate the students from the residents and each class of residents from
all others (construct validity). The in-training examination could not
separate first-year post-graduate level and second-year postgraduate level
residents. Resident performance ratings could distinguish only first-year
postgraduate level from third-year postgraduate level residents. Residents
uniformly agreed that the OSCE measured important clinical objectives
attesting to its content validity. Reliability for the OSCE was calculated
at the 0.8 to 0.83 range. It is concluded that valid and reliable clinical
examinations in pediatrics are feasible, practical, and highly desirable.
