Performance-Based Assessment in Child and Adolescent Psychiatry Residency Training.

Abstract

This study aimed to examine the application of the Objective Structured Clinical Examination (OSCE) to the assessment of competency among child and adolescent psychiatry (CAP) residents and to analyze the feedback from the residents and the examiners. The OSCE was administered to 53 CAP residents based on three seniority levels over a 14-year period. The results of 147 OSCEs applied to residents and the feedback received were evaluated. OSCE scores were calculated based on the scores given by the examiners and standardized patients (SPs). Examiners' communication skills scores were significantly higher than examiners' task performance scores but were not significantly different than the SPs' scores. Intraclass correlation coefficients indicated that examiners and SPs were very consistent in their assessments among themselves. The scores given by the examiners and the SPs were not different between genders except for female residents' communication skills scores given by SPs in the OSCE-senior. With regard to the feedback on the OSCE, it was determined that examiners gave significantly higher scores than residents on every item except for "neutrality of the examiners." A standard OSCE including different station types was structured to assess the progressive clinical skills of residents over the years. Using the OSCE contributed to CAP residency training far beyond assessment, creating a useful educational experience for both the trainers and the residents. Despite the challenge experienced related to SPs, the OSCE was found to be useful in improving training programs.