title: Assessment of clinical competence of medical students using the objective structured clinical examination: first 2 years' experience in Taipei Veterans General Hospital.
abstract: BACKGROUND
  Competence-oriented education is currently the mainstream method of teaching clinical medical education. The objective structured clinical examination (OSCE) is a widely employed and accepted tool to measure the clinical competence of medical students. We describe the first 2 years' experience of OSCE in Taipei Veterans General Hospital.
  
  
  METHODS
  At Taipei Veterans General Hospital, every 7(th)-year medical student has taken the OSCE since 2006. There were 15 stations in the first 2 years' OSCEs. In years 1 and 2, 133 and 132 students were assessed by the OSCE, respectively. The content of the OSCE included internal medicine, surgery, pediatrics, obstetrics and gynecology, communication, and emergency training. All categories and results of examinees' evaluation at each station were recorded inclusively and compared statistically.
  
  
  RESULTS
  The average scores of students from the 15 stations ranged from 47.7 ± 16.4 to 93.7 ± 8.5 in 2007. The score for communication skills was the lowest, whereas the score for Micro-Sim was the highest. Communication skills and electrocardiography interpretation were the 2 categories in which most of the students failed. A reliability analysis was conducted of the 2007 OSCE questions. The overall score and reliability (Cronbach's reliability) was 0.641. The difference between the impacts on reliability after deleting a test item ranged from 0.59 to 0.65 for all stations. This meant that every station had a similar impact on reliability after being deleted. The squared multiple correlation, R(2), of the reliability of each item was between 0.12 and 0.49, with chest X-ray interpretation being the lowest. The item-total correlation was between 0.10 and 0.41, with interactive case being the lowest.
  
  
  CONCLUSIONS
  The OSCE is an effective method for assessing the clinical competence of medical students. The OSCE could be improved further by modifying the examination questions and promoting effective training for standardized patients and examiners.
authors.affiliation: Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.forename: Cho-Yu
authors.initials: CY
authors.lastname: Chan
authors.forename: Chun-Lien
authors.initials: CL
authors.lastname: Wu
authors.forename: Ya-Lin
authors.initials: YL
authors.lastname: Chen
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Yang
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Huang
authors.forename: Chen-Huan
authors.initials: CH
authors.lastname: Chen
authors.forename: William J
authors.initials: WJ
authors.lastname: Huang
authors.forename: Fa-Yauh
authors.initials: FY
authors.lastname: Lee
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods*; D006787:Hospitals, Veterans; D006801:Humans; D012189:Retrospective Studies; D013337:Students, Medical; D013624:Taiwan