title: Performance of an objective structured clinical examination in a national certification process of trainees in rheumatology.
abstract: OBJECTIVE
  To assess reliability and validity of the objectively-structured clinical examination (OSCE) applied in postgraduate certification processes by the Mexican Board of Rheumatology.
  
  
  METHODS
  Thirty-two (2013) and 38 (2014) Rheumatology trainees (RTs) underwent an OSCE consisting of 12 and 15 stations respectively, scored according to a validated check-list, as well as 300-multiple-choice 300 question examination (MCQ). Previously, 3 certified rheumatologists underwent a pilot-OSCE. A composite OSCE score was obtained for each participant and its performance examined.
  
  
  RESULTS
  In 2013, OSCE mean score was 7.1±0.6 with none RT receiving a failing score while the MCQ score was 6.5±0.6 and 7 (21.9%) RTs receiving a failing (< 6) score. In 2014, the OSCE score was 6.7±0.6, with 3 (7.9%) RTs receiving a failing score (2 of them also failed MCQ) while the MCQ score was 6.4±0.5 and 7 (18.5%) RTs were disqualified (2 of them also failed OSCE). A significant correlation between the MCQ and the OSCE scores was observed in the 2013 (r=0.44; P=0.006). Certified rheumatologists performed better than RTs at both OSCE. Overall, 86% of RTs obtaining an OSCE passing score also obtained a MCQ passing score, while this was only 67% (P=.02) among those who obtained an OSCE failing score. Nine stations were applied at both consecutive years. Their performance was similar in both certification processes, with correlation coefficients ranging from 0.81 to 0.95 (P≤0.01).
  
  
  CONCLUSIONS
  The OSCE is a valid and reliable tool to assess the Rheumatology clinical skills in RTs.
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México. Electronic address: virtichu@gmail.com.
authors.forename: Virginia
authors.initials: V
authors.lastname: Pascual Ramos
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Medrano Ramírez
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Eunice
authors.initials: E
authors.lastname: Solís Vallejo
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Ana Guilaisne
authors.initials: AG
authors.lastname: Bernard Medina
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Diana Elsa
authors.initials: DE
authors.lastname: Flores Alvarado
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Margarita
authors.initials: M
authors.lastname: Portela Hernández
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Lilia
authors.initials: L
authors.lastname: Andrade Ortega
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Olga
authors.initials: O
authors.lastname: Vera Lastra
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Rolando
authors.initials: R
authors.lastname: Espinosa Morales
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Miranda Limón
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: María Del Rocío
authors.initials: Mdel R
authors.lastname: Maldonado Velázquez
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Luis Javier
authors.initials: LJ
authors.lastname: Jara Quezada
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Luis Manuel
authors.initials: LM
authors.lastname: Amezcua Guerra
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Judith
authors.initials: J
authors.lastname: López Zepeda
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Saavedra Salinas
authors.affiliation: Consejo Mexicano de Reumatología, México DF, México.
authors.forename: Cesar Alejandro
authors.initials: CA
authors.lastname: Arce Salinas
mesh_terms: D002568:Certification / Q000592:standards*; D002983:Clinical Competence / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D006801:Humans; D008800:Mexico; D015203:Reproducibility of Results; D012219:Rheumatology / Q000193:education* / Q000592:standards
keywords: Certificación, Reumatología; Certification, Rheumatology; Desempeño clínico; Examen clínico objetivo estructurado; Objectively-structured clinical examination; Trainee