title: How well do second-year students learn physical diagnosis? Observational study of an Objective Structured Clinical Examination (OSCE).
abstract: 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.
authors.affiliation: Geriatric Medicine Unit, Massachusetts General Hospital, 100 Charles River Plaza, Fifth Floor, Boston, MA, USA. chamann@partners.org
authors.forename: Claus
authors.initials: C
authors.lastname: Hamann
authors.forename: Kevin
authors.initials: K
authors.lastname: Volkan
authors.forename: Mary B
authors.initials: MB
authors.lastname: Fishman
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Silvestri
authors.forename: Steven R
authors.initials: SR
authors.lastname: Simon
authors.forename: Suzanne W
authors.initials: SW
authors.lastname: Fletcher
mesh_terms: 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