title: Evolution of the OSCA-OSCE-Clinical Examination of the Royal Australasian College of Surgeons.
abstract: The Objective Structured Clinical Assessment (OSCA) was introduced by the Royal Australasian College of Surgeons in 1990. Over the last 5 years important changes have been made to the format of the examination to improve the processes of the examination overall and its reliability and validity. Competency scores have been introduced to comprise 25% of the score for each station to allow an additional judgement by the examiner of clinical competence beyond the structure objective marking scale. The examination has changed to a purely clinical examination with an increase in stations from 12 to 16 and deletion of the written component. The name has progressively changed from OSCA to Objective Structured Clinical Examination to Clinical Examination. The roles of the clinical committee have been refined and a database of station questions has been developed. This enables a blueprint matrix of clinical skills and specialty classifications to ensure a broad representation of stations on each examination. The database also allows information to be collected about the performance of stations and statistical analysis has shown the current clinical exam to have an overall reliability of approximately 0.7, which is a good level of reliability. Progressively stations with low correlation are being reduced and reproducibility across multiple centres is being assessed. In the 18 years since this examination was introduced multiple changes have refined the processes, reliability and validity of the examination.
authors.affiliation: Department of General Surgery, Alfred Hospital, Melbourne, Victoria, Australia. serpellhome@bigpond.com
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Serpell