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objective structured clinical examinations (osces), psychiatry and the clinical assessment of skills and competencies (casc)same evidence, different judgement客观结构化临床考试(osce),精神病学和临床技能和能力评估(casc)同样的证据,不同的判断
Marwaha BMC Psychiatry 2011, 11:85
/1471-244X/11/85
DEBATE Open Access
Objective Structured Clinical Examinations
(OSCEs), psychiatry and the Clinical assessment
of Skills and Competencies (CASC)Same Evidence,
Different Judgement
Steven Marwaha
Abstract
Background: The Objective Structured Clinical Examination (OSCE), originally developed in the 1970’s, has been
hailed as the “gold standard” of clinical assessments for medical students and is used within medical schools
throughout the world. The Clinical assessment of Skills and Competencies (CASC) is an OSCE used as a clinical
examination gateway, granting access to becoming a senior Psychiatrist in the UK.
Discussion: Van der Vleuten’s utility model is used to examine the CASC from the viewpoint of a senior
psychiatrist. Reliability may be equivalent to more traditional examinations. Whilst the CASC is likely to have
content validity, other forms of validity are untested and authenticity is poor. Educational impact has the potential
to change facets of psychiatric professionalism and influence future patient care. There are doubts about
acceptability from candidates and more senior psychiatrists.
Summary: Whilst OSCEs may be the best choice for medical student examinations, their use in post graduate
psychiatric examination in the UK is subject to challenge on the grounds of validity, authenticity and educational
impact.
Background examiners were not always consistent over time [4].
The Objective Structured Clinical Examination (OSCE), This subjectivity, the potential for examiner bias [5], and
originally developed in the 1970’s, has been hailed as the the use of small numbers of real cases was also linked to
“gold standard” of clinical assessments for medical st
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