General Information
Name of Exams:
(OSCE) Observed Structured Clinical Examination
Second-Year OSCE
Senior (often called 4th – year OSCE)
Main Contact:
Jennie Struijk, M.Ed., Operations Director, UW OSCE Program
David Losh, M.D., Medical Director, UW OSCE Program
Registration:
Second-Year OSCE dates will be assigned by college.
Third-Year students will register for the Senior OSCE during Fourth-Year scheduling
Schedule:
Second-Year OSCE Part A – mornings during January
Second-Year OSCE Part B – mornings during April
Senior OSCE – mornings during early July and early August (one morning per student)
Examination (OSCE) Information
OSCE Definition:
OSCE stands for "Observed Standardized Clinical Examination". A classic "OSCE" involves student interviewing or examining a standardized patient who is taught to act and respond in a standard way, time after time regardless of who is doing the interview. We also employ other ways of testing clinical skills during the OSCE such as written exercises, computer simulations, and mannequins. OSCEs may include:
- History, and physical exams with standardized patients (see: What is a Focused History or Exam?)
- Short written tests / Mannequins / Computer cases
- Test Interpretation
- Patient education
- Order writing
- Professionalism/ethics
“The OSCE method, as used today, has evolved into a flexible testing approach that can incorporate standardized patients (SPs) as well as observer ratings, short written tests, and other methods … to provide a comprehensive clinical evaluation of history taking, physical examination and communication skills.” *
* Turner JL, Dankoski ME, Objective structured clinical exams: a critical review, Fam Med, 2008;40(8):574-8.
When OSCEs are given at the University of Washington
OSCEs are administered to students during their second-year in medical school and at the beginning of their Senior Year in medical school. The Second-Year OSCEs are administered over two blocks of time – one in early January, and a second in March and April. The senior OSCEs are done in July or August of the senior year.
The Number of Cases used for Each Examination
Each examination consists of 9 to 10 cases. The Second-year examination is split into two testing periods of 4 and 6 cases respectively. All 9 or 10 Senior OSCE cases are administered in one sitting for each student.
What OSCEs Test
OSCEs test a variety of clinical skills. They include communication/interviewing skills, physical examination skills, clinical reasoning skills, clinical knowledge, and the ability to integrate all of these skills.
The clinical skills and content measured on the OSCEs are not limited to a particular set of Benchmarks or clinical guidelines. When each of the various OSCE examinations are administered, the content and format of the particular examination is selected to test skills and knowledge that students have already been exposed to in the curriculum.
Content for the OSCEs is drawn from:
- The full range of clinical skills and benchmarks taught in ICM I and II
- Principles taught in the Ethics course and other clinically relevant required courses
- Principles identified in the goals and objectives of the required clinical clerkships.
Particular attention should be given to the content accessible via the following links when preparing for the Second-year and Senior OSCEs:
ICM 2 Clinical Skills (listed in the ICM II website)
Physical Exam Benchmarks
Medical Interviewing (Communication Benchmarks)
Cultural Communications Guidelines (Appendix A of the Medical Interviewing Benchmarks)
Professionalism Benchmarks
Ethics Benchmarks
Plus, for the Senior OSCE, attention to content taught in each of the required Clerkships.
The Grading Scale Used to Report Results at the UW
At the University of Washington, student performance on each case is graded using the following scale:
EE = Exceeds Expectations
ME = Meets Expectations
ND = Needs Development
Some cases simply measure whether a concept or skill is achieved or not. Therefore, not all cases are designed to allow for exceeding expectations.
Why OSCEs are Used at the University of Washington
Every LCME accredited medical school in the United States requires OSCEs to assess student’s clinical skills and the effectiveness of the curriculum.
There are a number of additional reasons why OSCEs are used.
- They prepare students to take the required Clinical Skills licensing Examination (CSE) (This preparation has helped UW students as a whole, to do better than the national average on this examination.)
- They give students some feedback on their interviewing and examination skills
- They help identify strengths and weaknesses in the curriculum.
- They help identify students that need additional help or coaching prior to entering the clinical years or graduating from medical school
- They help emphasize the importance of clinical skills in the curriculum.
The Difference Between the Second-year OSCE and the Senior OSCE
Great care is taken to design each examination to test clinical skills that are appropriate to the level of training. At the second-year level most cases are designed to be 5 to 12 minutes long. They are usually designed around a specific clinical task eg. take part of a history, do a specific part of a physical examination, answer a specific professional or ethical question, etc. At the Senior level, some of the cases are longer (23-25 minutes) and test the students ability to integrate history taking, physical exam, documentation skills, and clinical reasoning (differential diagnosis, and plan). The Senior OSCE also uses a variety of shorter testing formats to measure the student’s knowledge of different clinical concepts that are taught in the clerkships.