Objective Structured Practical Evaluation (OSPE)/ Objective Structured Clinical Evaluation (OSCE)

To enhance assessment and to provide a greater degree of objectivity and consistency in clinical assessment, Harden (1975) developed an Objective Structured Clinical Evaluation (OSCE) and implemented this form of clinical assessment into the curriculum. Boursicot and Roberts elaborated on implementation of OSCE and OSPE (objective structured practical examination) in an undergraduate medical course. The National Assessment & Accreditation Council (2.5.11- Page 59) and Dental Council of India (DCI) in its revised regulations recommend use of the OSCE or OSPE as a tool for assessing dental students’ skills (Dental Council of India. Regulations for the degree of Bachelor of Dental Surgery 2007, The Gazette of India Extraordinary, New Delhi, September 10, 2007).

For dental student, the acquisition of clinical competence is of supreme importance. Hence, a teaching and assessment method which emphasizes clinical competence is extremely vital. Apparently, traditional written examinations test a different kind of knowledge from that acquired during clinical assessments. Clinical experience may be better judged by the clinical supervisor than by assessment of theoretical knowledge. A good assessment of student should include both clinical skills and factual knowledge, therefore an OSCE/ OSPE should be complemented by written (essay-type or multiple choice questions) and oral exams (viva voice).

  • OSCE/OSPE provides unprecedented feedback about students understanding and pinpoints areas of confusion.

  • The OSCE has also been judged to be a valuable method in assessing students progress toward competence.

  • Evaluating candidate using OSCE/ OSPE method is innovative, comprehensive, well structured, objective, and fair and provided scope for self-evaluation also.

  • In traditional clinical/practical examination/ assessment systems, all the important skills may not be tested; unequal time may be available to perform the procedures; and at times, patients may exhibit unease and noncooperation. Students to have their grievances about this method, viz. feeling that what they did well went unobserved while other students were getting away with mistakes and perceiving a lack of clarity about what skill is being tested and the level of performance expected. OSCE/OSPE has been shown not only to overcome these drawbacks of the traditional assessment system but also to improve the validity and reliability of assessment.

  • The steering effect of examinations is well known. "Steering effect" means that students learn best those subjects on which they expect to be examined. This effect should be taken into account when evaluating students. Thus, when the student bears in mind that he/she will be expected to perform well on an OSCE, then he/she will really have to learn the necessary skills.

  • As an evaluation tool, it eliminates the luck of the draw, reduces variation in marking standards from examiner to examiner, and can accurately reflect the real-life tasks of the doctor.

  • It measures competencies through performance examinations as it is not uncommon that a student cannot perform a properly focused clinical examination of the patient, even if he or she claims to have done a complete clinical examination.

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