Use of a group objective structured clinical examination with first-year medical students.


To evaluate the implementation of a quarterly group objective structured clinical examination (GOSCE) to assess the patient-evaluation abilities of a medical school class.
The study subjects were 94 first-year students participating in the Principles of Clinical Medicine course at the Oregon Health Sciences University School of Medicine in 1992-93. To create the GOSCE, the authors modified the format of the quarterly objective structured clinical examination by making each standardized-patient station the site of an interaction between a standardized patient and a group of four or five students. The GOSCE's reliability, content and face validity, and expense were evaluated. Student feedback was obtained using a structured questionnaire.
Performances varied both among the five stations of the GOSCE and among the 23 student groups: the mean percentage of items performed correctly per station was 83%, with a range of 73-97%. The reliability of the GOSCE's stations was low, with intraclass correlations during the three consecutive quarters of .29, .05, and .12. Despite no prior experience with this type of testing, the students' mean rating of the GOSCE's appropriateness was 3.8 (on a Likert scale of 1, poor, to 5, excellent), compared with 2.5 for the appropriateness of the written examination also used for quarterly assessment. The expense of the GOSCE was much less than the costs reported for the OSCE format.
The use of the quarterly GOSCE favorably influenced the students, faculty, and curriculum. The GOSCE format made possible the assessment of a large number of students' abilities, without the time and expense needed to evaluate students individually.


  • Publisher Full Text
  • Authors

    Elliot DL

    Department of Medicine, Oregon Health Sciences University School of Medicine, Portland.

    Fields SA

    Keenen TL

    Jaffe AC

    Toffler WL


    Academic medicine : journal of the Association of American Medical Colleges 69:12 1994 Dec pg 990-2


    Clinical Competence
    Clinical Medicine
    Cost-Benefit Analysis
    Education, Medical, Undergraduate
    Educational Measurement
    Faculty, Medical
    Medical History Taking
    Physical Examination
    Reproducibility of Results
    Students, Medical

    Pub Type(s)

    Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't



    PubMed ID