Predictive validity of measurements of clinical competence using the team objective structured bedside assessment (TOSBA): assessing the clinical competence of final year medical students.
BACKGROUND
The importance of valid and reliable assessment of student competence and performance is gaining increased recognition. Provision of valid patient-based formative assessment is an increasing challenge for clinical teachers in a busy hospital setting. A formative assessment tool that reliably predicts performance in the summative setting would be of value to both students and teachers.


OBJECTIVE
This study explores the utility of the team objective structured bedside assessment (TOSBA), a novel ward-based formative assessment tool, in predicting student performance in the final clinical examination.


METHODS
The performance of a cohort of final year students (n = 191) in the TOSBA was compared with their subsequent performance in the final examination. A comparison was also made between student performance in the existing formative assessment tool, the objective structured long examination record (OSLER) and the final examination. We also examined the relationship between the TOSBA and the components of the final examination using clustering around latent variables analysis.


RESULTS
There was a clear relationship between student performance in the TOSBA and performance in the final examination (r(2) = 0.35). Student performance in the OSLER showed a poor relationship with performance in the final examination (r(2) = 0.15) compared with the TOSBA. The TOSBA results showed particular correlation with specific components of the final examination which were clinically based.


CONCLUSIONS
TOSBA performance is a strong predictor of subsequent performance in the final examination. The clustering of the TOSBA with other assessments of clinical skills underlines its utility. Further research is required to determine whether performance in the TOSBA is predictive of subsequent performance during internship.
Meagher
Frances M
FM
Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland. fmeagher@rcsi.ie
Butler
Marcus W
MW
Miller
Stanley D W
SD
Costello
Richard W
RW
Conroy
Ronan M
RM
McElvaney
Noel G
NG
D002983:Clinical Competence / Q000592:standards*; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods*; D006126:Group Processes; D006784:Hospitals, Teaching; D006801:Humans; D013337:Students, Medical