• Black JE
• Gloar CD
• Werner VL

• Association of Chiropractic Colleges / congresses

METHODS: In order to develop the formative OSCE the practical components (e.g. history taking) had to be determined. We had to know the class size, the amount of time needed to perform each aspect of the examination, the timing format for the three stations, the number of testing sites, and the number of examiners needed. A survey was developed and administered after the completion of the formative OSCEs concerning the students’ feelings of preparedness for the OSCEs prior to and subsequent to the formative OSCE. The summative OSCE consists of three stations concerning one case. The history is elicited; an examination is performed; and the student has to complete a management station consisting of diagnosis, management, and follow-up.

RESULTS: The largest expenditure in creating the formative and summative OSCEs was manpower time. Ten individuals developed cases for the formative OSCE exams. All faculty from the student clinic and as many as five faculty from the outpatient clinics acted as examiners for a total of 32 testing hours (including the summative OSCE) during the spring trimester of 2005. In addition, seven staff persons participated in assisting with the OSCE testing (moving the students from station to station, timing each station, setting up the testing sites, and returning the clinic to normal operations after the conclusion of each formative OSCE.) The summative examination used 20 examiners, 12 staff members and a coordinator for the examination. Prior to the formative OSCEs, with the exception of the x-ray OSCE, 81% of the students felt extremely prepared or prepared for the formative OSCE, while only 49% of the students felt extremely prepared or prepared for the x-ray OSCE. Subsequent to the formative OSCEs, excluding the x-ray OSCE, a mean of 75% of the students felt that they had been extremely prepared or prepared for the OSCE. However, only 57% of the students felt that they had been prepared for the x-ray OSCE.

DISCUSSION: This study is limited in that reliability is enhanced by increasing the number of stations; each formative and summative OSCE had only three stations. There are advantages and disadvantages to an OSCE assessment. The advantages are that the OSCE is more reliable and more valid and that a large number of students can be tested. The disadvantages are that the students are tested in compartments; the OSCE is demanding for both examiners and patients; and the time invested in setting up an OSCE is greater than for a traditional examination. Although, in conclusion, there were only three stations in the summative OSCE, the students performed tasks (history, examination, and management) on the same patient case. The Clinical Methods class syllabus was changed to reflect the OSCE scores, both formative and summative, so that they would comprise 80% of the final grade.

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