Objective Structured Clinical Examination (OSCE) in Psychiatry Education: A Review of Its Role in Competency-Based Assessment

Abstract

Over the last two decades, Objective Structured Clinical Examination (OSCE) has become an increasingly important part of psychiatry education and assessment in the Australian context. A reappraisal of the evidence base regarding the use of OSCE in psychiatry is therefore timely. This paper reviews the literature regarding the use of OSCE as an assessment tool in both undergraduate and postgraduate psychiatry training settings. Suitable articles were identified using the search terms 'psychiatry AND OSCE' in the ERIC (educational) and PubMed (healthcare) databases and grouped according to their predominant focus: (1) the validity of OSCEs in psychiatry; (2) candidate preparation and other factors impacting on performance; and (3) special topics. The literature suggests that the OSCE has been widely adopted in psychiatry education, as a valid and reliable method of assessing psychiatric competencies that is acceptable to both learners and teachers alike. The limited evidence base regarding its validity for postgraduate psychiatry examinations suggests that more research is needed in this domain. Despite any shortcomings, OSCEs are currently ubiquitous in all areas of undergraduate and postgraduate medicine and proposing a better alternative for competency-based assessment is difficult. A critical question is whether OSCE is sufficient on its own to assess high-level consultancy skills, and aspects of professionalism and ethical practice, that are essential for effective specialist practice, or whether it needs to be supplemented by additional testing modalities.

Students’ perception and scores in Paediatrics end-of-clerkship and final professional Objective Structured Clinical Examination (OSCE): A comparative study

“…2 The OSCE is superior to the oral clinical examination because it assesses a broad area of competency, resulting in better reliability and validity. 3 The OSCE has demonstrated validity and reliability for assessing medical trainees' clinical skills in multiple disciplines. 3,4 Literature supports the use of OSCEs to evaluate clinical knowledge and competence, professional judgment, problem-solving skills, and interpersonal and communication skills.…”

“…3 The OSCE has demonstrated validity and reliability for assessing medical trainees' clinical skills in multiple disciplines. 3,4 Literature supports the use of OSCEs to evaluate clinical knowledge and competence, professional judgment, problem-solving skills, and interpersonal and communication skills. [5][6][7] The combination of OSCE with standardized board examinations has the potential to become the gold standard for measuring physician competence.…”

Sexual Health in Child and Adolescent Psychiatry: Multi-Site Implementation Through Synchronized Videoconferencing of an Educational Resource Using Standardized Patients

“…Simulation with SPs offers learners an opportunity to gain exposure to a wide range of patients and clinical scenarios, and to practice and refine clinical skills in a safe and supportive environment ( 38 ). Although widely used in undergraduate medical education, simulation-based training in post-graduate psychiatric training is considerably more limited ( 39 – 41 ). SP use in CAP training is virtually non-existent, partly because of the additional practical, legal, and ethical considerations inherent to working with underage actors ( 42 ).…”

Performance-Based Assessment in Child and Adolescent Psychiatry Residency Training

“…In an OSCE, there are various stations where residents are expected to perform certain tasks to achieve given objectives [3]. Although the examiners, station duration, and assessment methods may vary, the use of the same criteria and time constraints to assess candidates' performance of a task is an essential characteristic of all OSCEs [8].…”