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Abstract
Background: Adoption of the objective structured clinical examination may be hindered by shortages of clinicians within a specialty. Clinicians from other specialties should be considered as alternative, non-expert examiners.
Aims: We assessed the inter-rater agreement between expert and non-expert clinician examiners in an integrated objective structured clinical examination for final year medical undergraduates.
Methods: Pairs of expert and non-expert clinician examiners used a rating checklist to assess students in 8 oral communication stations, representing commonly encountered scenarios from medicine, paediatrics, and surgery. These included breaking bad news, managing an angry relative, taking consent for lumbar puncture; and advising a mother on asthma and febrile fits, and an adult on medication use, lifestyle changes and post-suture care of a wound. 439 students participated in the OSCE (206 in 2005, 233 in 2006).
Results: There was good to very good agreement (intraclass coefficient: 0.57–0.79) between expert and non-expert clinician examiners, with 5 out of 8 stations having intraclass coefficients ≥0.70. Variation between paired examiners within stations contributed the lowest variance to student scores.
Conclusion: These findings support the use of clinicians from other specialties, as ‘non-expert’ examiners, to assess communication skills, using a standardized checklist, thereby reducing the demand on clinicians’ time.
Additional information
Notes on contributors
Mee Lian Wong
MEE LIAN WONG conceived the study.MEE LIAN WONG was the main writer of the paper. She also analyzed the data and coordinated the OSCE with the other team members.
Calvin S. L. Fones
CALVIN FONES conceived the study.CALVIN FONES was the Chairman of the OSCE.
Marion Aw
MARION AW conceived the study.MARION AW designed the Paediatrics questions. The other authors contributed the OSCE questions for medicine, and surgery.
Chay Hoon Tan
CHAY HOON conceived the study.
Poh Sim Low
POH SIM LOW was Chair of the assessment committee.POH SIM LOW designed the Paediatrics questions. The other authors contributed the OSCE questions for medicine, and surgery.
Zubair Amin
ZUBAIR AMIN conceived the study.ZUBAIR AMIN designed the Paediatrics questions. The other authors contributed the OSCE questions for medicine, and surgery.
Poh Sun Goh
POH SIM LOW was Chair of the assessment committee.POH SIM LOW designed the Paediatrics questions. The other authors contributed the OSCE questions for medicine, and surgery.