A snapshot of current Objective Structured Clinical Examination (OSCE) practice at Australian medical schools

Abstract

Objective: The objective of this collaborative study was to compare current practices of conducting high-stake, exit-level Objective Structured Clinical Examinations (OSCEs) at all Australian medical schools. We aimed to document similarities and differences between schools, and compare existing practice against available gold standard, evidence-based practice. We also aimed to identify areas where gold standards do not currently exist, and could be developed in the future.

Methods: A 72-item semi-structured questionnaire was sent to all 19 Australian medical schools with graduating students.

Results: A total of 18/19 schools responded. Of these, 16/18 schools had summative exit-level OSCEs representing content from multiple medical specialties. The total number of OSCE stations varied from 8 to 16, with total OSCE testing time ranging from 70 to 160 min. All schools blueprinted their OSCE to their curriculum, and trained simulated patients and examiners. There was variation in the format of marking rubric used.

Conclusions: This study has provided insight into the current OSCE practices of the majority of medical schools in Australia. Whilst the comparative data reveal a wide variation in OSCE practices between schools, many recommended “gold standard” OSCE practices are implemented. The collective awareness of our similarities and differences provides us with a baseline platform, as well as an impetus for iterative quality improvement. Such discourse also serves to develop new gold standards in practice where none have previously existed.

Acknowledgments

The authors would like to thank administrative and academic staff from all participating schools.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Notes on contributors

Clare Heal

Dr. Clare Heal, MBChB, DRANZCOG, DipGUMed, MPHTM, PhD, is a Professor of General Practice and Rural Medicine at James Cook University in Mackay, Queensland. In addition to her research activities, she is a chair of Year 5 assessment and co-ordinator of general practice for JCU. She is a member of an expert exam item-writing panel for the Australian Medical Council and is a co-chair of ACCLAIM.

Karen D’Souza

Karen D’Souza, MBBS (Hons), leads Clinical Curriculum and Assessment at the School of Medicine, Deakin University. She chairs the School’s OSCE Committee and is a Co-Chair of the ACCLAiM Collaboration (Australian Collaboration for Clinical Assessment in Medicine). Her areas of research interest include OSCEs, simulation, selection, clinical and communication skills.

Jennifer Banks

Dr. Jennifer Banks, PhD, MBS, BBS, is a senior research officer with College of Medicine and Dentistry, James Cook University.

Bunmi S. Malau-Aduli

Bunmi S. Malau-Aduli, BSc, MSc, GradCertMgt, GradCertULT, PhD, is an Associate Professor in Medical Education and the Academic Lead for Assessment and Evaluation at the College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia.

Richard Turner

Richard Turner, MBBS, BMedSC, FRACS, is Professor of Surgery in the College of Health and Medicine, University of Tasmania. He is a practising General Surgeon, whose research interests include anal neoplasia, pancreatitis, men’s health, and clinical assessment. He has had a number of examiner roles with the Royal Australasian College of Surgeons and General Surgeons Australia.

Jane Smith

Jane Smith, MBBS, FRACGP, MHS, is an Associate Professor of General Practice and Year 5 Head, Bond University Medical Program. Jane became a full time academic after years as a GP. As well as educating medical students in General Practice, she has been responsible for many Clinical Year Examinations, creating research interests in OSCE assessments, medical education and general practice.

Ebony Bray

Ebony Bray is a 6th-year MBBS student with James Cook University, College of Medicine and Dentistry.

Lizzi Shires

Lizzi Shires, MBBS, FRACGP, is a Rural GP on the North West Coast of Tasmania and Director of the Rural Clinical School, University Tasmania. She is currently chair of Final Year with responsibility for exit examinations.

Ian Wilson

Professor Ian Wilson (MBBS, PhD, FRACGP, FAMEE), Director of Learning and Teaching, School of Medicine, University of Wollongong. Following graduation from University of Adelaide, Professor Wilson became a GP. He has always had a significant interest in medical education and over the last 12 years has worked almost fulltime in education. Current research interests include student selection, professionalism, and professional identity formation.