How well do second-year students learn physical diagnosis? Observational study of an Objective Structured Clinical Examination (OSCE).
BACKGROUND
Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course.


METHODS
Cross-sectional study at Harvard Medical School, 1997-1999, for 489 second-year students.


RESULTS
Average total OSCE score was 57% (range 39-75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p <.0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p <.0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p <.0001).


CONCLUSIONS
Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.
Hamann
Claus
C
Geriatric Medicine Unit, Massachusetts General Hospital, 100 Charles River Plaza, Fifth Floor, Boston, MA, USA. chamann@partners.org
Volkan
Kevin
K
Fishman
Mary B
MB
Silvestri
Ronald C
RC
Simon
Steven R
SR
Fletcher
Suzanne W
SW
D000124:Achievement; D002983:Clinical Competence / Q000592:standards; D003430:Cross-Sectional Studies; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D010808:Physical Examination / Q000592:standards*; D015203:Reproducibility of Results