The emperor's new clothes: the OSCE reassessed.
In response to increasing concerns about the prevalence of knowledge- based assessments of medical student competency, leaders in medical education have emphasized the importance of methods that quantify student performance. As a result, the use of objective structured clinical examinations (OSCEs) is viewed by many as the newest and most promising technique for assessing students' abilities. In considering the implementation of a fourth-year OSCE, faculty at the College of Human Medicine at Michigan State University became uncomfortable with some of the technical limitations of the method (limited generalizability; weak linkages to the curriculum; little opportunity provided for improvement in examinees' skills; and others), as well as the possible ramifications of such an innovation within their school's specific curricular and organizational contexts. This essay is offered as a reflection of the challenges and possible alternatives that have emerged as the faculty have considered how best to design and implement performance-based assessment within their institution. Rather than using the OSCE as a milestone marker of student performance, they consider the possibility of smaller assessment events, closely tied to the curriculum and consistent with the guiding principles of the medical school.
Mavis
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Office of Medical Education Research and Development, College of Human Medicine, Michigan State University, East Lansing 48824-1316, USA. mavis@pilot.msu.edu
Henry
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Ogle
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Hoppe
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D000046:Academic Medical Centers; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D008824:Michigan