Introducing the Objective Structured Clinical Examination to a family practice residency program.

BACKGROUND: The Objective Structured Clinical Examination (OSCE) is a multiple station examination where examinees are expected to demonstrate mastery of a competency within a specified time at each station. It is commonly used to evaluate medical students and is less often used in residency programs. This paper describes the process of introducing a 12-station OSCE to a university-based family practice residency program. METHODS: The examination evaluated cognitive, psychomotor, and behavioral competencies in 31 residents. The 10-minute stations included: two simulated patients; two skills demonstrations; six modified essay questions, four in response to a written scenario and two in response to a video trigger; and two rest stations. Feedback was given in a large group at the conclusion of the examination. RESULTS: Construct validity was demonstrated by increasing scores with training year; concurrent validity was demonstrated by significant correlations of the OSCE scores with the American Board of Family Practice in-training examination scores and the residents' monthly rotation evaluation scores. Reliability was demonstrated by significant correlation between the scores of the OSCE and its subsets. CONCLUSIONS: As a method of formative evaluation, the OSCE had an overall positive response from residents and faculty.