The influence of testing context and clinical rotation order on students' OSCE performance.
OBJECTIVE
To investigate the influence of testing context and rotation order on third-year medical student performance on a common objective structured clinical examination (OSCE) station in both obstetrics-gynecology (ob-gyn) and psychiatry rotations.


METHODS
Archival OSCE performance data (in the form of a 25-item binary content checklist) from one class of third-year medical students (n = 141) at Saint Louis University (2002-03) were aggregated and analyzed.


RESULTS
Despite the fact that the station was identical in both OSCEs, students were, in general, less likely to inquire about ob-gyn issues on the psychiatry OSCE and less likely to inquire about psychiatric issues on the ob-gyn OSCE, regardless of order of rotation. Order did have a positive effect on some results, such that students were more likely to mention menopause and vaginal dryness on the psychiatry OSCE if they had already had the ob-gyn rotation.


CONCLUSIONS
The testing context may influence student approaches to patients in ways that bias their collection and interpretation of information. OSCE evaluations may better approximate true clinical context and complexity by presenting case scenarios that reflect a broader range of diagnostic possibilities than those limited to the recently completed rotation.
Blaskiewicz
Robert J
RJ
Saint Louis University School of Medicine, Missouri, USA. blaskier@slucare1.edu
Park
Robin S
RS
Chibnall
John T
JT
Powell
Jill K
JK
D000328:Adult; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000592:standards* / Q000639:trends; D004521:Educational Measurement; D005069:Evaluation Studies as Topic; D005260:Female; D006176:Gynecology / Q000193:education; D006801:Humans; D008297:Male; D009774:Obstetrics / Q000193:education; D011336:Probability; D011570:Psychiatry / Q000193:education; D013337:Students, Medical; D013647:Task Performance and Analysis