Abstract
Assessment of medical students in their emergency medicine (EM) clerkship is often based on clinical shift evaluations and written examinations. Clinical evaluations offer some insight into students’ ability to apply knowledge to clinical problems, but are notoriously unreliable, with score variance that may be driven as much by error as by actual student performance.1–6 Clinical evaluations are also limited by the unpredictability of pathology in emergency department (ED) patients, and by patient safety considerations that prevent students from independently managing patients, especially those with high-acuity conditions. Additionally, there is evidence that the basic skills of history and physical exam are rarely observed by faculty members, and the feedback they receive on these domains is limited.7–9 These factors hinder EM educators in their effort to objectively assess students’ progress relative to clerkship objectives, particularly those that pertain to emergent care. The objective structured clinical exam (OSCE) is one potential solution to these problems. Described in 1975 by Harden et al, an OSCE is designed to assess the clinical competence of medical trainees through direct observation of skill performance in a variety of stations.10 OSCEs have been widely adopted in medical education and in other health professions.11–13 These exams are viewed as a valuable form of clinical assessment due to their demonstrated reliability and inherent flexibility for assessing a wide variety of knowledge application and skills.11 In EM, OSCEs have been used mainly in postgraduate medical education to assess resident communication skills and clinical performance.14,15 One OSCE for interns was shown to accurately predict future clinical performance scores.12 A recently published evaluation of an EM OSCE for medical students demonstrated validity evidence supporting this method of assessment.16 These studies suggest that OSCEs can be used effectively in EM education, and yield valid assessment data.
Highlights
Assessment of medical students in their emergency medicine (EM) clerkship is often based on clinical shift evaluations and written examinations
Described in 1975 by Harden et al, an objective structured clinical exam (OSCE) is designed to assess the clinical competence of medical trainees through direct observation of skill performance in a variety of stations.[10]
We developed the OSCE based on the EM Milestones, with the goal of assessing the majority of the clinicallyoriented competencies described in that framework
Summary
Assessment of medical students in their emergency medicine (EM) clerkship is often based on clinical shift evaluations and written examinations. There is evidence that the basic skills of history and physical exam are rarely observed by faculty members, and the feedback they receive on these domains is limited.[7,8,9] These factors hinder EM educators in their effort to objectively assess students’ progress relative to clerkship objectives, those that pertain to emergent care. In EM, OSCEs have been used mainly in postgraduate medical education to assess resident communication skills and clinical performance.[14,15] One OSCE for interns was shown to accurately predict future clinical performance scores.[12] A recently published evaluation of an EM OSCE for medical students demonstrated validity evidence supporting this method of assessment.[16] These studies suggest that OSCEs can be used effectively in EM education, and yield valid assessment data
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