Clinical Skills Assessment: Comparison of Student and Examiner Assessment in an Objective Structured Clinical Examination

Background: Learning of basic clinical skills is introduced in Years 1 and 2 of the MBBS Program at the Aga Khan University, Pakistan, through a structured Clinical Skills Teaching program. Acquisition of competence in performing these skills is assessed through use of the Objective Structured Clinical Examination (OSCE). Self-assessment is defined broadly as the involvement of learners in judging whether or not learner-identified standards have been met. Objective: We compared Year 2 students' self-assessment of clinical skills with examiners' assessment of performance in an OSCE using a standard rating scale. Methods: A self-assessment questionnaire was completed by all Year 2 students immediately after the OSCE. Students assessed their performance at three stations, using a performance rating scale. Examiners observed and evaluated the students during history-taking and physical examination using the same rating scale. Results: There were significant positive correlations between examiners' assessments of performance and students' self-assessed ratings in taking consent, obtaining demographic information, history of presenting problems and summarization. Significant differences were observed in pre-procedural skills, comment on prostate, liver palpation percussion and spleen percussion. Conclusions: Findings highlight the strengths and weaknesses in clinical competence at the end of Year 2 and provide a direction to improve the gaps in the Clinical Skills Teaching program.