An objective structured clinical examination for evaluating psychiatric clinical clerks
An objective structured clinical examination for evaluating psychiatric clinical clerks
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DOI：
10.1097/00001888-199708000-00019
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发表时间：
1997-08-01
影响因子：
7.4
通讯作者：
McNaughton, N
中科院分区：
文献类型：
--
作者：
Hodges, B;Regehr, G;McNaughton, N
目的.评估客观结构化临床考试（OSCE）的可行性、信度和效度。1995年，多伦多大学医学院开发了两种平行形式的10站OSCE（8个临床站，2个书写站）。每一个12分钟的基于性能的临床站进行了评估，由一名精神科教师使用两个清单，每个学生的性能内容和性能过程的全球评级量表。学生的临床站分数计算为他们的内容和过程分数的平均值（以百分比表示）。考官还记录了对每个学生表现的总体判断（及格、勉强及格或不及格），并[与该站的标准化患者（SP）合作]对每个学生的表现撰写评论。通过等级有两个标准：所有十个站的总分为60%或更高，八个临床站中至少有五个站的“通过”或“边缘”分数。每个OSCE表格管理三次。第一份表格用于检查94名职员，第二份表格用于检查98名职员。两种形式的平均得分分别为70.47%（SD，6.33%）和67.66%（SD，7.05%）。除了收集学生的标准评估信息外，还发生了几起严重事件（例如，学生的损失;控制情绪），这可能会发现潜在的问题，在专业行为。一次考试的直接费用约为3，300加元：其中最大的一部分是特别程序员用于培训和履行职责的时间。初步证据表明，精神病学欧安组织是可行的评估复杂的精神病技能。然而，必须仔细注意SP培训，考试监控，检测关键事件，并提供反馈给学生，教师和SP。该大学以前的口试制度每年需要大约600个学时。OSCE需要大约450个学时，节省的150个学时几乎可以支付每年考试的2万加元费用。总之，欧安组织是一个评估系统，具有可证明的可靠性，是更愉快的教师和学生。
Purpose. To assess the feasibility, reliability, and validity of an objective structured clinical examination (OSCE) for psychiatric clinical clerks.Method. In 1995 two parallel forms of a ten-station OSCE (eight clinical stations, two writing stations) were developed at the University of Toronto Faculty of Medicine. Each 12-minute performance-based clinical station was assessed by a faculty psychiatrist using both a checklist for each student's performance content and a global-rating scale of the performance process. The students' clinical-station scores were calculated as the average of their content and process scores (expressed as percentages). Examiners also recorded an overall judgment of each student's performance (pass, borderline, or fail) and wrote [in collaboration with the standardized patient (SP) at that station] comments on each student's performance. There were two criteria for a passing grade: a total mark of 60% or higher across all ten stations and a ''pass'' or ''borderline'' mark in at least five of the eight clinical stations. Each OSCE form was administered three times.Results. The first form was used to examine 94 clerks, the second form to examine 98 clerks. The students' mean scores for the two forms were 70.47% (SD, 6.33%) and 67.66% (SD, 7.05%), respectively. In addition to the standard evaluation information collected on the students, several critical incidents occurred (e.g., a student's loss;of control of emotions) that may identify potential problems in professional conduct. The direct cost for one administration of the examination was approximately Can$3,300: the largest portion of this was for the SPs' time spent in training and performing their roles.Conclusion. Preliminary evidence suggests that a psychiatry OSCE is feasible for assessing complex psychiatric skills. However, careful attention must be paid to SP training, examination monitoring, detection of critical incidents, and provision of feedback to students, faculty, and SPs. The university's previous system of oral examinations required approximately 600 faculty hours per year. The OSCE requires approximately 450 faculty hours, and the 150 hours saved almost cover the Can$20,000 that the examination costs each year. In all, the OSCE is an evaluation system that has demonstrable reliability and is more enjoyable for both the faculty and the students.