title: Design and validation of 2 objective structured clinical examination stations to assess core undergraduate examination skills of the hand and knee.
abstract: OBJECTIVE
  To evaluate the development, validity, and reliability of 2 undergraduate Objective Structured Clinical Examination (OSCE) stations for core hand and knee examination skills.
  
  
  METHODS
  Two OSCE stations for hand and knee based on core skills were developed, and qualitatively assessed for face and content validity by an expert consensus panel. Construct validity was evaluated by comparing the performance of third- (n = 21) and fifth-year (n = 50) medical students with 6 specialist registrars (SpR) in rheumatology. Concurrent validity was evaluated by correlating the scores of the fifth-year students with their eventual final examination scores. The fifth-year data were used to calculate the interrater and intrarater reliabilities of 2 examiners. Intrarater reliability analyzed repeat scores using videotapes of the examinations.
  
  
  RESULTS
  Both stations were deemed to fulfil face and content validity criteria by the expert consensus panel. There was no significant difference in the mean scores of the third- and fifth-years. There were significant differences in the mean scores between both student groups and the SpR in both stations consistent with a valid construct theory. The fifth-year hand OSCE results correlated moderately with other indices of clinical skills, but not knowledge, and satisfied concurrent validity. Inter- and intrarater reliability for both stations was high.
  
  
  CONCLUSIONS
  These OSCE stations are valid and reliable tools for testing competency in core hand and knee examination skills. They can be used in educational research as outcome measures of specific teaching interventions and can also be used as an early feedback tool when teaching joint examination.
authors.affiliation: Department of Rheumatology, Derbyshire Royal Infirmary, Derby, UK. Nicholas.raj@nhs.net
authors.forename: Nicholas
authors.initials: N
authors.lastname: Raj
authors.forename: Louisa J
authors.initials: LJ
authors.lastname: Badcock
authors.forename: George A
authors.initials: GA
authors.lastname: Brown
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Deighton
authors.forename: Sheila C
authors.initials: SC
authors.lastname: O'Reilly
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards*; D006225:Hand / Q000502:physiology*; D006801:Humans; D007717:Knee / Q000502:physiology*; D015588:Observer Variation; D010808:Physical Examination / Q000379:methods*; D015203:Reproducibility of Results; D012219:Rheumatology / Q000193:education*