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BMC Med Educ. 2017 Apr 24;17(1):71. doi: 10.1186/s12909-017-0908-1.

Examiner effect on the objective structured clinical exam - a study at five medical schools.

Author information

1
Department of Orthopaedics, Trauma Surgery and Sportsmedicine, Agaplesion ev. Hospital Giessen, Paul-Zipp-Str.171, 35398, Giessen, Germany. iris.schleicher@ortho.med.uni-giessen.de.
2
Department of Orthopaedics, Trauma Surgery and Sportsmedicine, Agaplesion ev. Hospital Giessen, Paul-Zipp-Str.171, 35398, Giessen, Germany.
3
Department of Psychosomatic and General Internal Medicine, University of Heidelberg, 69120, Heidelberg, Germany.
4
Present address: Institute for medical and pharmaceutical tests, Große Langgasse 8, 55116, Mainz, Germany.
5
Center of Excellence in Medical Assessment, Faculty of Medicine, University of Heidelberg, im Neuenheimer Feld 346, 69120, Heidelberg, Germany.
6
Department of Trauma, Hand and Reconstructive Surgery, University of Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany.
7
Department of General Surgery, University of Frankfurt, Theodor Stern Kai, 60590, Frankfurt am Main, Germany.
8
Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, 35043, Marburg, Germany.
9
Department of General Surgery, University of Goettingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
10
Present address: Institute for medical education and educational research, Josef-Schneider-Str. 2/D6, 97080, Würzburg, Germany.

Abstract

BACKGROUND:

The Objective Structured Clinical Examination (OSCE) is increasingly used at medical schools to assess practical competencies. To compare the outcomes of students at different medical schools, we introduced standardized OSCE stations with identical checklists.

METHODS:

We investigated examiner bias at standardized OSCE stations for knee- and shoulder-joint examinations, which were implemented into the surgical OSCE at five different medical schools. The checklists for the assessment consisted of part A for knowledge and performance of the skill and part B for communication and interaction with the patient. At each medical faculty, one reference examiner also scored independently to the local examiner. The scores from both examiners were compared and analysed for inter-rater reliability and correlation with the level of clinical experience. Possible gender bias was also evaluated.

RESULTS:

In part A of the checklist, local examiners graded students higher compared to the reference examiner; in part B of the checklist, there was no trend to the findings. The inter-rater reliability was weak, and the scoring correlated only weakly with the examiner's level of experience. Female examiners rated generally higher, but male examiners scored significantly higher if the examinee was female.

CONCLUSIONS:

These findings of examiner effects, even in standardized situations, may influence outcome even when students perform equally well. Examiners need to be made aware of these biases prior to examining.

KEYWORDS:

Assessment; Bias; Medical student; OSCE; Practical skills

PMID:
28438196
PMCID:
PMC5402669
DOI:
10.1186/s12909-017-0908-1
[Indexed for MEDLINE]
Free PMC Article

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