Assessment of English proficiency in international medical graduates by physician examiners and standardized patients.

Abstract

Since 1986, the Ontario Ministry of Health has provided a medical licensure preparation programme for international medical graduates. Because of the diversity in candidates' oral English proficiency, this competency has been viewed as a particularly important selection criterion. To assess and compare the quality of ratings of oral English proficiency of international medical graduates provided by physician examiners and by standardized patients (SPs). PARTICIPANTS AND MATERIALS: The study samples consisted of 73 candidates for the Ontario International Medical Graduate (IMG) Program, and physician examiners and SPs in five 10-minute encounter objective structured clinical examination (OSCE) stations. Materials used were a seven-item speaking performance rating instrument prepared for the Ontario IMG Program. Rating sheets were scanned and the results analysed using SPSS 9.0 for Windows. Correlations between the physician and SP ratings on the seven items ranged from 0.52 to 0.70. The SPs provided more lenient ratings. Mean alpha reliability for the physicians' ratings on the seven items was 0.59, and for the SPs' 0.64. There was poor agreement between the two sets of raters in identifying problematic candidates. Notwithstanding the sizable correlations between the ratings provided by the two rater groups, the results demonstrated that there was little agreement between the two groups in identifying the potentially problematic candidates. The physicians were less prone than the SPs to rate candidates as problematic. SPs may be better placed than the physician examiners to directly assess IMG candidates' oral English proficiency.