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What's an OSCE?

OSCE is an acronym for Objective Structured Clinical Examination, an assessment method that is based on objective testing and direct observation of student performance during planned clinical encounters (also called interactions or test stations). Studies have demonstrated that the OSCE is an effective tool for evaluating areas most critical to performance of health care professionals: the ability to obtain information from a patient, establish rapport and communicate, and interpret data and solve problems.

Originally described by Harden (1975), the OSCE includes several "stations" in which examinees are expected to perform specific clinical tasks within a specified time period (as brief as 5 minutes to 30 minutes or longer). To complete the examination, students rotate through a series of stations (as few as 2 or as many as 20).

OSCE stations can involve several methods of testing, including use of multiple choice or essay tests, but most often are planned clinical encounters in which a student interacts with a standardized patient (SP). Evaluation criteria are based on course objectives and student learning activities.

The types of problems portrayed in an OSCE are those students would commonly encounter in a clinic or hospital. Patients are usually adults, although some could present with problems relating to their spouses or family members.

Monitored stations, where a trained observer scores the student's performance, are used for encounters such as taking a patient history, performing a physical examination or diagnostic procedure, or teaching/counseling/advising a patient. A rating form or standardized checklist clearly specifies the evaluation criteria and the scoring system to be used for each station. The more items marked as "done" on the checklist, the higher the score.

Marker stations, when a student is asked to answer questions, write a report or a prescription, or record or interpret findings such as lab reports and x-rays, are not observed.

Sometimes a station is followed by a post-encounter (also called interstation or tag station) where the student is expected to answer questions about the encounter (What is your differential diagnosis? What test would you order?) or to write a note.