How do formative objective structured clinical examinations drive learning? Analysis of residents’ perceptions

Abstract

Introduction: Although several studies have explored the relationship between learning and written tests, little is understood about how performance-based examinations influence learning. The purpose of this study was to explore how a formative objective structured clinical examination (OSCE) drives learning.

Methods: We administered surveys to residents (n = 35) at three time points to determine if and how an OSCE influenced their learning: before and immediately following the OSCE, and after the distribution of their results. Differences in quantitative responses between high- and low-performing residents and across time were compared using repeated-measures ANOVA. Thematic analysis was used to analyze narrative comments.

Results: Participants’ goals for the OSCE related to performance, mastery and feedback. Almost all participants reported that they had learned something from the OSCE (94%) and most participants generated learning goals after the OSCE (71%). High performers appeared to recognize the importance of content-related knowledge for scoring well before and after the OSCE, whereas low performers may have under-estimated its importance until after the examination.

Discussion: Participants viewed a formative OSCE as both a hurdle to overcome (assessment of learning) and an opportunity to learn (assessment for learning). Understanding how OSCEs influence study behavior can help guide the development of assessments that promote learning.

Disclosure statement

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

Glossary

Formative assessment: A discussive form of assessment that guides future learning, provides reassurance, promotes reflection, and shapes future values.

Reference: Epstein R. (2007) Assessment in Medical Education. New England Journal of Medicine; 356:387–396.

Notes on contributors

Debra Pugh, MD, MHPE, FRCPC, is an Associate Professor, Department of Medicine, University of Ottawa.

Isabelle Desjardins, MD, MMEd (candidate), FRCPC, is an Assistant Professor, Department of Medicine, University of Ottawa.

Kevin Eva, PhD, is a Professor, Department of Medicine, University of British Columbia and Senior Scientist at the Centre for Health Education Scholarship (CHES).

Additional information

Funding

This work was supported by Department of Innovation in Medical Education (DIME), University of Ottawa; Department of Medicine, The Ottawa Hospital.