Objective structured clinical examination for teaching and assessment: Evidence-based critique

Abstract

Almost 50 years ago, objective structured clinical examination (OSCE) was introduced as a comprehensive and objective tool to assess clinical competencies in a standardized manner. OSCE has not only been used as an assessment tool but also an effective teaching modality. Over the years, the validity, feasibility, reliability and objectivity of OSCE have been questioned. Also, given the need for a large number of stations and examiners, high costs, elaborate checklists, training of examiners and standardization of patients, the acceptance of OSCE has been reluctant. The COVID 19 pandemic saw OSCE in its new avatar and virtual OSCE was used extensively to ensure undisrupted teaching and assessment of medical students worldwide. The recent Competency Based Medical Education (CBME) Guidelines for medical education in India have internalized OSCE as an assessment modality for medical undergraduates. This article focuses on the issues of validity, objectivity, reliability, and standard setting of OSCE and describes the challenges and way ahead for implementation of OSCE in India.

Keywords

• Competency-based medical education
• Reliability
• Validity
• Virtual OSCE