The new MRCOG Objective Structured Clinical Examination - the examiners evaluation

Abstract

Following criticism of the clinical and viva sections of the previous Part II MRCOG examination, the Royal College of Obstetricians and Gynaecologists (RCOG) introduced an objective structured clinical examination (OSCE) in November 1998. This replaced the previous clinical and viva voce sections and was designed to allow a fairer, more reliable and more reproducible method of candidate assessment. We set out to document the examiners' response to the first MRCOG Part II OSCE and to evaluate their assessment of the new format compared to the old. We conducted a retrospective survey of all 76 examiners involved in the new style OSCE format. A questionnaire was posted to all examiners and a further questionnaire was sent out to the initial non-responders. The questionnaire was designed to determine whether or not examiners had examined for the MRCOG Part II before and if so to evaluate their assessment of the new format compared to the old. All examiners were then asked to score each OSCE station. The score represented the examiners view of the station's ability to assess the clinical skill that it had been designed to test. Median scores were determined for each question. A space was provided for general comments. Seventy-two of 76 examiners returned their questionnaires (two were excluded), a 95% response rate. Seventy-eight per cent of examiners had examined before and considered the standard of the exam to be comparable with the old format, a median score of 3 (range 1-5). In addition they found the OSCEs to be a much fairer method of candidate assessment, median score 4 (range 1-5). The majority of median scores relating to OSCE stations were 4 and 5, suggesting that examiners felt the stations assessed the candidates, clinical skills adequately. Sixty-eight of 70 (97%) examiners felt the new format should remain and 57 of 70 (81%) felt it would be suitable for adoption by other specialities. The first MRCOG Part II OSCE was generally well received by the examiners and was an organisational success. Our survey of examiners revealed that the new format was considered to be of the same standard as previous examinations, but that the new format was perceived to be much fairer. The majority of OSCE stations adequately tested the clinical skills they were designed to assess. With ongoing evaluation and development it is anticipated that this proportion will increase. The success of the new format suggests that OSCEs will remain as the final clinical examination for postgraduate obstetrics and gynaecology.