David Newble

Techniques for measuring clinical competence: objective structured clinical examinations.

The traditional clinical examination has been shown to have serious limitations in terms of its validity and reliability. The OSCE provides some answers to these limitations and has become very popular. Many variants on the original OSCE format now exist and much research has been done on various aspects of their use. Issues to be addressed relate to organization matters and to the quality of the assessment. This paper focuses particularly on the latter with respect to ways of ensuring content validity and achieving acceptable levels of reliability. A particular concern has been the demonstrable need for long examinations if high levels of reliability are to be achieved. Strategies for reducing the practical difficulties this raises are discussed. Standard setting methods for use with OSCEs are described.

International handbook of research in medical education

No wonder you activities are, reading will be always needed. It is not only to fulfil the duties that you need to finish in deadline time. Reading will encourage your mind and thoughts. Of course, reading will greatly develop your experiences about everything. Reading international handbook of research in medical education is also a way as one of the collective books that gives many advantages. The advantages are not only for you, but for the other peoples with those meaningful benefits.

The Parallel Rural Community Curriculum: an integrated clinical curriculum based in rural general practice

In an attempt to address the rural medical workforce maldistribution and the concurrent inappropriate caseload at the urban tertiary teaching hospitals, Flinders University and the Riverland Division of General Practice decided to pilot, in 1997, an entire year of undergraduate clinical curriculum in Australian rural general practice. This program is called the Parallel Rural Community Curriculum (PRCC). This paper is a discussion of the aims of the programme; student selection; practice recruitment; curriculum structure, and academic content, together with lessons learnt from the evaluation of the first cohort of students’ experience of the course.

Strategic Planning in Medical Education: Enhancing the Learning Environment for Students in Clinical Settings

The 1999 Cambridge Conference was held in Northern Queensland, Australia, on the theme of clinical teaching and learning. It provided an opportunity for groups of academic medical educators to consider some of the challenges posed by recent changes to health care delivery and medical education across a number of countries.

The use of portfolios for assessment of the competence and performance of doctors in practice.

Backgroundu2002 The use of portfolios can potentially provide flexibility in the summative assessment of doctors in practice. An assessment system should reflect and reinforce the active and planned professional development goals of individual doctors. This paper discusses some of the issues involved in developing such a system.

The selection and training of examiners for clinical examinations.

The inconsistency of the marking in clinical examinations is a well documented problem. This project identified some of the factors responsible for this inconsistency.

Selecting performance assessment methods for experienced physicians

Backgroundu2002 While much is now known about how to assess the competence of medical practitioners in a controlled environment, less is known about how to measure the performance in practice of experienced doctors working in their own environments. The performance of doctors depends increasingly on how well they function in teams and how well the health care system around them functions.

Standard setting in an objective structured clinical examination : use of global ratings of borderline performance to determine the passing score

Objective structured clinical examination (OSCE) standard‐setting procedures are not well developed and are often time‐consuming and complex. We report an evaluation of a simple ‘contrasting groups’ method, applied to an OSCE conducted simultaneously in three separate schools.

The Certification and Recertification of Doctors: Issues in the Assessment of Clinical Competence

Ed David Newble, Brian Jolly, Richard Wakeford Cambridge University Press, £37.50, pp 249 ISBN 0-521-43187-5nnIt is a truth (almost) universally acknowledged that assessment of both postgraduate and undergraduate medical students should be valid, reliable, and fair, but unfortunately it is rarely any of these and never all. Why? Valid means that it tests what we want it to test and tests what it says it will. Thus assessments must relate to real problems, because we need to be certain that our assessments relate to real medicine in order to have any chance of inferring that students competence in the assessments is relevant to their performance “in real life.”nnReliable means we can be sure of getting the same result next time. Assessments need to be reliable so that when we pass …

Assuring the quality of high-stakes undergraduate assessments of clinical competence

In the UK, and in many Commonwealth countries, a university degree is accepted by registration bodies as an indication of competence to practice as a PRHO or intern. Concerns have been raised that the quality of university examinations may not always be sufficient for such high-stakes decision-making. Assessments of clinical competence are subject to many potential sources of error. The search for standardization, and high validity and reliability, demands the identification and reduction of measurement errors and biases due to poor test design or variation in test items, judges, patients or examination procedures. Generalizability and other research studies have identified where the likely sources of error might arise and have been taken into account in the development of published guidelines on international best practice, which institutions should strive to follow. The purpose of this paper is to describe the development of the integrated final-year assessment of clinical competence at the University of Sheffield. The aim was to introduce a range of strategies to ensure the examination met the best practice guidelines. These included blueprinting the assessment to achieve a high degree of content validity; lengthening the examination by adding a written component to the OSCE component to ensure an adequate level of reliability; providing training and feedback for examiners and simulated patients; paying attention to item development; and providing statistical information to assist the examination committee in standard setting and decision-making. This evidence-based approach should be readily achievable by all medical schools.