Objective structured clinical examinations as an assessment method in residency training: practical considerations

T he assessment of residents in training relies mostly on testing their knowledge by writt t ten examinations (multipletchoice tests), ast t sessing their competence using clinical examinations (long and short case oral examinations), and on rating their performance using end of rotations rating forms.Unfortunately, the assessment of competence using clinical examinations has its limitations because of low reliability and validity.Because of improved reliability and validity, the objective structured clinical examinat t tion (OSCE) is a more accurate means of assessing the clinical competence of residents.The objective of this review is to provide a practical guide to the role and use of the OSCE as an assessment tool and includes a det t scription of its format, advantages, disadvantages, orgat t nization, standards setting, reliability, validity, and utilt t ity.The OSCE provides a more reliable assessment of trainee competency compared to the traditional clinical examination.It complements other methods commonly used such as multichoice questions, and end of rotation ratings of performance.Ensuring proper sampling of the competencies to be assessed and an adequate number of stations, proper training of examiners and standardized patients is important in obtaining reliable and valid ast t sessments.Setting standards by using the borderline approach is practical and accurate when compared with other absolute methods.The OSCE needs to be made part of the assessment process for residents in training.Accurate assessment of trainees is essential to prot t vide them with feedback, to make decisions about their advancement from one level of training to the next and about their successful completion of training.It provides important information to improve the traint t ing process and to identify poorly performing trainees that need help.Moreover, accurate assessment protects the community from incompetent trainees that do not Objective structured clinical examinations as an assessment method in residency training: practical considerations