Using an objective structured clinical examination (OSCE) to assess multiple physician competencies in postgraduate training.
BACKGROUND
Competency-based models of medical education require reliable and valid assessment of multiple physician roles.


OBJECTIVE
To develop and evaluate an objective structured clinical examination (OSCE) designed to assess 7 physician competencies (CanMEDS Roles).


METHODS
Twenty four candidates from 4 neonatal-perinatal medicine training programs participated in a 10-station OSCE. Ten 5-point rating scales were developed and used to assess the CanMEDS Roles of Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar and Professional. Three descriptors of performance anchored the ratings. For each station, examiners completed appropriate CanMEDS ratings, a station-specific binary checklist and an overall process-related global rating. Trained standardized patients (SP) and standardized health professionals (SHP) completed rating scales that assessed verbal and non-verbal expression, empathy and coherence as well as the overall global rating.


RESULTS
Each station incorporated 3-5 physician Roles. Interstation alpha was 0.80 for checklist scores and 0.88 for examiners' overall global rating. Median interstation alpha for individual CanMEDS ratings was 0.72 (range 0.08-0.91). There were significant correlations between examiner Medical Expert scores and SP/SHP overall global scores and between examiner Communicator scores and 4 SP/SHP assessments of communication skills. Second year trainees' CanMEDS scores for each competency were significantly higher than those of first year trainees (p < 0.05).


CONCLUSIONS
The OSCE may be useful as a reliable and valid method of simultaneously assessing multiple physician competencies.
Jefferies
Ann
A
University of Toronto, Toronto, Ontario, Canada. ajefferies@mtsinaion.ca
Simmons
Brian
B
Tabak
Diana
D
McIlroy
Jodi Herold
JH
Lee
Kyong-Soon
KS
Roukema
Henry
H
Skidmore
Martin
M
D002983:Clinical Competence; D003142:Communication; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D004645:Empathy; D005240:Feasibility Studies; D006801:Humans; D009359:Neonatology / Q000193:education; D010500:Perinatology / Q000193:education; D010819:Physician's Role; D010820:Physicians; D015203:Reproducibility of Results