Comparing Objective Structured Clinical Examinations and Traditional Clinical Examinations in the Summative Evaluation of Final year Medical Students.

Abstract

Introduction: Medical schools have traditionally assessed medical students using long and short cases. Objective structured clinical examination (OSCE) has been found to be more reliable. Aim: To compare OSCE and traditional method of assessment in the summative assessment of final year medical students. Methods: This was a descriptive cross-sectional retrospective study of summative assessment of final year medical students at Enugu State University of Science  and  Technology  (ESUT)  College  of Medicine. Ethical clearance was obtained. Department of Internal Medicine organized clinical examinations consisting of long case and short case. Department of Surgery organized an OSCE consisting of two parts. The A part (Picture OSCE, replacing traditional short case) and the B part (Clinical OSCE, replacing traditional long case). Students' scores in the traditional examination, OSCE and final total score in both Internal Medicine and Surgery were collated and subjected to analysis with SPSS version 23 (IBM; SPSS, Chicago, IL, USA). Pearson correlation was used to assess correlations, paired T test was used to compare mean scores and Cronbach's Alpha used to assess reliability. P< 0.05 was considered significant. Results:  Out of the 73 candidates sat for both Internal Medicine and Surgery, 41 were female and 32 were males giving a female: male ratio of 1.3:1. There was a positive correlation between students' score in clinical OSCE and long case, r = 0.525 (p= 0.000); students' score in short case and picture OSCE, r =0.450 (p = 0.003); and between scores in Internal Medicine clinical (Long case + Short case) and scores in Surgery clinical (picture OSCE + Clinical OSCE), r = 0.593 (p = 0.000). Using paired sample T test, there was a significant differences between the mean scores in long case (mean = 52.86, SD= 4.315) and scores in clinical OSCE (mean = 58.356, SD = 7.906), t (72) = -7.181, p = 0.000; mean scores in short case (mean = 52.86, SD = 4.097) and picture OSCE (mean = 48.580, SD = 8.992, t (72) = 4.558, p = 0.000; no significant difference between the mean total scores in Internal Medicine clinical (mean = 105.712, SD = 6.680) and Surgery clinical (mean = 106.915, SD = 15.846), t (72) = -0.788, p = 0.433. The Cronbach's Alpha for traditional examination and OSCE were 0.437 and 0.863 respectively. Conclusion: OSCE gives a similar mean score to traditional method when used as a summative assessment tool but OSCE is more reliable.