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Sharpening the eye of the OSCE with critical action analysis.
Acad Med. 2008 Oct; 83(10):900-5.AM

Abstract

PURPOSE

When interpreting performance scores on an objective structured clinical examination (OSCE), are all checklist items created equal? Although assigning priority through checklist item weighting is often used to emphasize the clinical importance of selected checklist items, the authors propose the use of critical action analysis as an additional method for analyzing and discriminating clinical performance in clinical skill assessment exercises. A critical action is defined as an OSCE checklist item whose performance is critical to ensure an optimal patient outcome and avoid medical error. In this study, the authors analyzed a set of clerkship OSCE performance outcome data and compared the results of critical action analysis versus traditional checklist item performance scores.

METHOD

OSCE performance scores of 398 third-year clerkship students from 2003 to 2006 at the University of Virginia School of Medicine were analyzed using descriptive statistics and a logistic regression model. Through a consensus process, 10 of 25 OSCE cases were identified as containing critical actions.

RESULTS

Students who scored above the median correctly performed the critical actions more often than those scoring lower. However, for 9 of 10 cases, 6% to 46% of higher-scoring students failed to perform the critical action correctly.

CONCLUSIONS

Failure to address this skill assessment outcome is a missed opportunity to more fully understand and apply the results of such examinations to the clinical performance development of medical students. Including critical action analysis in OSCE data interpretation sharpens the eye of the OSCE and enhances its value in clinical skill assessment.

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Authors+Show Affiliations

Payne NJ
University of Virginia School of Medicine, Charlottesville, Virginia 22908, USA.
Bradley EB
No affiliation info available
Heald EB
No affiliation info available
Maughan KL
No affiliation info available
Michaelsen VE
No affiliation info available
Wang XQ
No affiliation info available
Corbett EC
No affiliation info available

MeSH

AdultClinical ClerkshipClinical CompetenceCritical CareEducation, Medical, UndergraduateEducational MeasurementFemaleHumansInternal MedicineLogistic ModelsMaleOdds RatioPhysical ExaminationProbabilityProblem-Based LearningSchools, MedicalSensitivity and SpecificityStudents, MedicalTask Performance and AnalysisVirginia

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

18820517

Citation

Payne, Nancy J., et al. "Sharpening the Eye of the OSCE With Critical Action Analysis." Academic Medicine : Journal of the Association of American Medical Colleges, vol. 83, no. 10, 2008, pp. 900-5.
Payne NJ, Bradley EB, Heald EB, et al. Sharpening the eye of the OSCE with critical action analysis. Acad Med. 2008;83(10):900-5.
Payne, N. J., Bradley, E. B., Heald, E. B., Maughan, K. L., Michaelsen, V. E., Wang, X. Q., & Corbett, E. C. (2008). Sharpening the eye of the OSCE with critical action analysis. Academic Medicine : Journal of the Association of American Medical Colleges, 83(10), 900-5. https://doi.org/10.1097/ACM.0b013e3181850990
Payne NJ, et al. Sharpening the Eye of the OSCE With Critical Action Analysis. Acad Med. 2008;83(10):900-5. PubMed PMID: 18820517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sharpening the eye of the OSCE with critical action analysis. AU - Payne,Nancy J, AU - Bradley,Elizabeth B, AU - Heald,Evan B, AU - Maughan,Karen L, AU - Michaelsen,Veronica E, AU - Wang,Xin-Qun, AU - Corbett,Eugene C,Jr PY - 2008/9/30/pubmed PY - 2008/10/25/medline PY - 2008/9/30/entrez SP - 900 EP - 5 JF - Academic medicine : journal of the Association of American Medical Colleges JO - Acad Med VL - 83 IS - 10 N2 - PURPOSE: When interpreting performance scores on an objective structured clinical examination (OSCE), are all checklist items created equal? Although assigning priority through checklist item weighting is often used to emphasize the clinical importance of selected checklist items, the authors propose the use of critical action analysis as an additional method for analyzing and discriminating clinical performance in clinical skill assessment exercises. A critical action is defined as an OSCE checklist item whose performance is critical to ensure an optimal patient outcome and avoid medical error. In this study, the authors analyzed a set of clerkship OSCE performance outcome data and compared the results of critical action analysis versus traditional checklist item performance scores. METHOD: OSCE performance scores of 398 third-year clerkship students from 2003 to 2006 at the University of Virginia School of Medicine were analyzed using descriptive statistics and a logistic regression model. Through a consensus process, 10 of 25 OSCE cases were identified as containing critical actions. RESULTS: Students who scored above the median correctly performed the critical actions more often than those scoring lower. However, for 9 of 10 cases, 6% to 46% of higher-scoring students failed to perform the critical action correctly. CONCLUSIONS: Failure to address this skill assessment outcome is a missed opportunity to more fully understand and apply the results of such examinations to the clinical performance development of medical students. Including critical action analysis in OSCE data interpretation sharpens the eye of the OSCE and enhances its value in clinical skill assessment. SN - 1938-808X UR - https://www.unboundmedicine.com/medline/citation/18820517/Sharpening_the_eye_of_the_OSCE_with_critical_action_analysis_ L2 - https://doi.org/10.1097/ACM.0b013e3181850990 DB - PRIME DP - Unbound Medicine ER -