1. School of Clinical Medicine School of Clinical Medicine UNIVERSITY OF CAMBRIDGE UK Council problems with OSCE assessment Jonathan Silverman 2012

2. School of Clinical Medicine School of Clinical Medicine UNIVERSITY OF CAMBRIDGE Integrated but with what? Timing of stations compromises validity? Sacrificed validity for reliability? Reliable? Valid? Are you disadvantaging the thoughtful shy student? Is it a glorified knowledge test? Standard setting and how easy to get it wrong? Are the stations apples and pears? Has integration compromised the exam? Examiner training effective? What is the educational impact of all this? You can never get it right

3. School of Clinical Medicine School of Clinical Medicine UNIVERSITY OF CAMBRIDGE Utility function U = Utility R = Reliability V = Validity E = Educational impact A = Acceptability C = Cost W = Weight U = w r R x w v V x w e E x w a A x w c C

4. School of Clinical Medicine School of Clinical Medicine UNIVERSITY OF CAMBRIDGE Domain based marking The problem of atomised communication The concept of professional judgement and flexibility and contextualisation Internalised grids Why this might not work in communication The problem of too few domains

5. School of Clinical Medicine School of Clinical Medicine UNIVERSITY OF CAMBRIDGE Process Marking in information gathering stations: 7 overall scores Initiating the Session Problem Identification Problem Exploration Patient’s Perspective Non-verbal Communication Developing Rapport Providing Structure

6. Individual areas for guidance: overall areas marked only

7. School of Clinical Medicine School of Clinical Medicine UNIVERSITY OF CAMBRIDGE Content marking

9. Plus structured oral - 5 minutes