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OSCEs - FAQs - 2013

This was piloted in 2007, formally launched in September 2008 and was a huge success both then in subsequent years. I hope that we can count on the support of our excellent examiners from the last five years.

We will need 16 examiners from 8am to 2pm and 24 examiners from 1pm to 5.30pm. Each session starts with food and a brief training on the OSCEs and the score sheets, (8.00 to 8.45am and 1.00 to 1.45pm respectively)

Why are we doing this again?

As you know the ABPN has phased out the live portion of the exams over the last 4 -5 years, we now need to give the residents experience of observed interviews and rate them as part of the Clinical Skills Verification assessment for which there will be trainings again at the start of September 2013.

We are also required to have a Resident annual clinical examination by the ACGME. To give  experience of vignettes and to fulfill the ACGME requirement, we decided to implement an annual OSCE examination for all residents from PGY2 and up.

We thought this was an ideal opportunity to combine requirements for the Board exams with meeting a new ACGME requirement in an innovative, (and hopefully), fun way.

What on earth is an OSCE?

For those of you who have not had a chance to be involved with these before, the objective structured clinical examination (OSCE) was first described by Dr. Ronald Harden in the 1970s. As a new evaluation tool that allowed clinicians to be observed performing in many different clinical situations, the OSCE was a major improvement over oral examinations in which only one clinical encounter was observed. The OSCE also incorporated the technology of standardized patients first described by Barrows and Abrahamson in 1964. Unfortunately the ABPN will not accept the use of standardized patients for their exam.

OSCEs have become indispensable for the assessment of medical students, clinical clerks, interns, and residents and of candidates for licensure and certification. OSCEs are also used extensively for the assessment of the competence of other health professionals, including chiropractors, nurses, nurse practitioners, pharmacists, and physiotherapists.

An OSCE is a timed examination in which residents move from station to station, each station requiring performance in a simulated setting that often involves interaction with a standardized patient. The resident is typically required to demonstrate some combination of history taking, physical or mental status examination, counseling, or other aspect of patient management.

At each station, candidates’ performances are rated on checklists and global rating scales. In virtually every medical discipline, OSCEs have been extensively studied and established as performance-based assessment instruments with good validity and reliability. Indeed, because OSCEs have been shown to have a much higher reliability and validity than traditional and less structured oral examinations, they have grown in acceptance as a means of episodic performance-based assessment.

They can also be quite a lot of fun.

What format will the OSCEs at WPIC take?

Our OSCEs will take place in two half day blocks on Thursday September 19th 2013. More Senior Residents will be examined in the Morning session and more Junior Residents in the afternoon.

Each Resident will have two 15 minute video vignettes each followed immediately by a 15 minute discussion about the case with an examiner - through the rest of the OSCE “block” each Resident will also have the opportunity to do at least four 15 minute vignettes/patient management problems.

If I agree to be an examiner what will I have to do?

You will be allocated to one of the stations for either a morning or an afternoon session as your schedule allows.

In the discussion OSCE the Resident will present the case they have just seen and be asked, by the examiner, to give a presentation and outline a management plan.

In the vignettes the resident will be presented with a scenario and asked questions about it by the examiner.

For any and all of the stations you will be asked to complete a rating sheet for each Resident examined based on the core competencies. Each item will be rated using 9 points spanning 5 levels.  This is similar to the "milestones" rating.  You will be asked to give an overall milestone score for each candidate.

Level 1 = This resident is functioning at the level of skill for someone just starting in Psychiatry

Level 2 = This resident is functioning at a level where they are showing that they are learning these skills and implementing them in practice

Level 3 = This resident is showing good understanding of these skills but still requires some supervision and guidance

Level 4 = This resident is functioning at the level of someone ready to graduate from training and begin solo practice,

Level 5 = This resident is performing at the level of an expert or seasoned practitioner

What’s in it for me?

This is an educational activity and is thus eligible for the highest grading of ECUs when these are reintroduced. In addition this activity counts as type 2 CME hours.

If you haven’t already experienced this type of examination you will gain a fund of knowledge that is likely to help prepare your students and residents for such exams in the future.

You will contribute even more to the educational experience of the Residents and they will love you for so doing.

How do I sign up?

Please send an email to me and to Ms. Carolyn Dorn, dornca@upmc.edu, indicating whether you would be able to do a morning session or an afternoon session, or even both!