OSPE/OSCE

Objectives

DEFINITION, ORIGIN, USES, STRENGTHS, UNDERSTANDING OSPE/OSCE 30 MINUTES

LIMITATIONS, TYPES, WAY OF
ORGANIZATIONS, VARIATIONS AND LIST
OF RESPONSES TO THE PERCEIVED
LIMITATIONS OF OSPE/OSCE
Objectives

• The definition of OSPE/OSCE

• Origin, uses, strengths, limitations of OSPE/OSCE
• Types of OSPE/OSCE
• Way of organization of OSPE/OSCE
• Variations of OSCE
• List of responses to the perceived limitations of OSCE
Definition: OSCE

OSCE : Objective Structured Clinical Examination generally used for clinical

subjects is an approach to assessment of clinical competence in which the
components of competence are assessed in a well planned or structured way
with attention being paid to objectivity of the examination.
Cont ….

OBJECTIVE: Here examiners use checklist for evaluating candidates.

STRUCTURAL: clinical skills or procedure is broken down into component parts

in a very structured way. Stations are short, numerous and highly focused

CLINICAL: tasks are representatives of those faced in real clinical situations

EXAMINATION: because the skills are assessed in the form of examination.

Definition: OSPE
OSPE: ‘Objective Structured Practical Examination generally used for preclinical
and basic subjects is a new pattern of practical examination in which each
components of clinical competence is tested uniformly and objectively for all
the students who are taking up a practical examination at a given place.

Here competence of a student is evaluated for general experiments in terms of

identification of equipments / accessories of an experiment, handling of
instruments, procedure of experiments, interpretation of results, conclusion.
History & Purpose: OSCE/OSPE
Ronald M Harden and his group from Dundee University first described OSCE in
1975 and greater detail in 1979 which was later extended to OSPE to overcome
the problems with conventional clinical and practical examinations.

To assess students' performance on practical skills, clinical skills, communication

skills on the psychomotor and affective (attitude and behaviors) domains and
higher intellectual ability.
Advantages & Disadvantages: OSCE/OSPE
Advantage:
1. Comprehensive & valid, can cover wide range of contents/objectives.

2. Reliable as the task & examiners are constant. Everyone faces same problems
/ questions with same difficulty level.

3. Objective, ratings by the examiners do not vary for same performance of the
candidates.

Disadvantage: needs considerable time, effort, skills & teamwork to plan,

organize and evaluate.
Types of OSCE/OSPE stations
There are mainly two types of OSPE/OSCE
stations
• Procedure station
• Question station (Response station)
There are other type stations (depending on
the functions) also -
• Must pass station/ guillotine station
• Linked station
• Rest station
• Double or triple length station
Cont ….
Procedure/performance/observed station: Here, candidates perform a
laboratory practical procedure (in OSPE) or patient related clinical task (in OSCE)
& an observer observes and rate by using checklist or marking schedule. e.g.
performing benedict test, measuring BP, counseling a simulated patient.
Question / unobserved station: Here, students have to give written answer(s)
to one or more questions might be of multiple-choice variety (MCQ) or specific
short answer type (SAQ). e.g. identification and related questions of an
instrument, specimen viscera, microscopic structure; interpretation of an
investigation report/ X-ray/ image.
Differences between Procedural and
Question station
Procedural Station Question Station
1. It is an observe station 1. It is an un-observe station
2. Here patient (real, simulation) & dummy -- 2. No patient. Instruments, pictures etc.
present. present (materials).
3. Psychomotor domain is assessed as well as 3. Cognitive domain only.
affective domain.
4. Checklist is must. 4. Rating scale can be used.
5. Observer present. 5. Not present
6. Provision of screen. 6. Not so.
7. Assessment/marking is done at that moment. 7. Done in later time.
Organization of OSCE/OSPE by a
department:
The activities for setting up of OSCEs /OSPEs by a department can be discussed
under following broad headings-
1) Advance planning and preparation,
2) Activities on the day before the examination,
3) Activities on the day of examination and
4) Activities after the examination
Advance planning and preparation for
organizing OSCEs/OSPEs
• Preparing OSPE/OSCE questions by patients / real patients
faculty member • Use of mannequins / models and
• Examination schedules simulated modern machineries
• Organizer of the examination • Scoring the candidates in the
• Test matrix / blueprint procedure stations
• Choosing venue • The observers
• Number and duration of the stations • Scoring the answers of the question
stations
• Preparing the stations
• Students briefing
• Standardized patients / simulated
• Budget and refreshment
Limitations of OSCEs/OSPEs
• Stations often require trainees to perform isolated aspects of the clinical
encounter, which "deconstructs" the doctor-patient encounter
• OSCEs rely on task specific checklists, which tend to emphasize
thoroughness. But with increasing experience, thoroughness becomes less
relevant
• The limitations on what can be simulated constrain the type of patient
problems that can be used
OSCE variations:
• Objective Structured Practical Examination • Group Objective Structured Clinical
(OSPE) Experience (GOSCE)
• Objective Structured Practical Veterinary • Team Objective Structured Clinical
Examination (OSPVE) Encounter (TOSCE)
• Clinical Assessment of Skills and • Team Observed Structured Clinical
Competencies (CASC) Examination (TOSCE)
• Practical Assessment of Clinical Examination • Team Objective Structured Bedside
Skills (PACES) Assessment (TOSBA)
• Objective Structured Assessment of • Interprofessional Team Objective Structured
Technical Skill (OSATS) Clinical Examination (ITOSCE)
• Multiple Mini Interview (MMI) • Objective Structured Teaching Encounter
(OSTE)
Who should contribute to the evaluation of
OSCE?
• Examiners
• Simulated patients
• Candidates
• The committee and individuals responsible for the organization of the
examination
• External evaluators
• Administrative and support staff
• Clinicians
Perceived limitations of an OSCE and possible responses
SL No Limitations Response
The OSCE does not assess holistic approach to a Use the OSCE alongside other tools, such as portfolios and
01
patient work based assessment instruments.
The OSCE assess only a limited sample of Use of Blueprints to sample across the outcome domains,
02
competencies. the body and the core tasks
The OSCE is resource intensive With organizations, the resources required can be
03
contained. The cost-benefit ratio is favorable.
The role of the examiner is prescribed Within the set framework, the examiner can also use
04
his/her judgement
Only minimum competence is tested in OSCE The scoring system can also reflect excellence. More
05
advanced stations can be included
Some learning outcomes are difficult to assess in Performance in an OSCE can be triangulated with ratings
06
the OSCE from other assessments
Student’s behaviours are influenced by the Design the OSCE to be as close to real practice as possible
07
context
Thank You