Objective Structured Clinical Examinations (OSCEs), psychiatry and the Clinical assessment of Skills and Competencies (CASC)Same Evidence, Different Judgement 英文参考文献.docVIP

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Objective Structured Clinical Examinations (OSCEs), psychiatry and the Clinical assessment of Skills and Competencies (CASC)Same Evidence, Different Judgement 英文参考文献.doc

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Objective Structured Clinical Examinations (OSCEs), psychiatry and the Clinical assessment of Skills and Competencies (CASC)Same Evidence, Different Judgement 英文参考文献

MarwahaBMCPsychiatry2011,11:85 /1471-244X/11/85 DEBATE OpenAccess ObjectiveStructuredClinicalExaminations (OSCEs),psychiatryandtheClinicalassessment ofSkillsandCompetencies(CASC)SameEvidence, DifferentJudgement StevenMarwaha Abstract Background:TheObjectiveStructuredClinicalExamination(OSCE),originallydevelopedinthe1970’s,hasbeen hailedasthe“goldstandard”ofclinicalassessmentsformedicalstudentsandisusedwithinmedicalschools throughouttheworld.TheClinicalassessmentofSkillsandCompetencies(CASC)isanOSCEusedasaclinical examinationgateway,grantingaccesstobecomingaseniorPsychiatristintheUK. Discussion:VanderVleuten’sutilitymodelisusedtoexaminetheCASCfromtheviewpointofasenior psychiatrist.Reliabilitymaybeequivalenttomoretraditionalexaminations.WhilsttheCASCislikelytohave contentvalidity,otherformsofvalidityareuntestedandauthenticityispoor.Educationalimpacthasthepotential tochangefacetsofpsychiatricprofessionalismandinfluencefuturepatientcare.Therearedoubtsabout acceptabilityfromcandidatesandmoreseniorpsychiatrists. Summary:WhilstOSCEsmaybethebestchoiceformedicalstudentexaminations,theiruseinpostgraduate psychiatricexaminationintheUKissubjecttochallengeonthegroundsofvalidity,authenticityandeducational impact. Background examiners were not always consistent over time [4]. TheObjectiveStructuredClinicalExamination(OSCE), Thissubjectivity,thepotentialforexaminerbias[5],and originallydevelopedinthe1970’s,hasbeenhailedasthe theuseofsmallnumbersofrealcaseswasalsolinkedto “goldstandard”ofclinical assessments formedicalstu- perceivedunfairness. dents[1]andisusedwithinmedicalschoolsthroughout Thusthechargewasthatlongcaseslackedreliability theworld[2].IntermsofMiller’striangle[3]describing and validity and were unfair to those assessed. In his a framework for clinical assessment, OSCEs aim to seminalpaperonOSCEs,Harden[6]outlinedanalter- examineskillsandabilityatthe“showshow”level,with native, espousing its objectivity, its reliability and the an expectation