Throw Out The Checklists (To Determine OSCE Failure)!  A Global Competent/Not Competent Rating Is Better

osce  Forty-seven residents were video-taped performing procedures on simulators during an observed structured clinical examination (OSCE).  Trained raters filled out traditional checklists as well global ratings including one for “overall ability to perform procedure”.  Any “not competent” rating generated a written comment.  There was near perfect inter-rater reliability for overall competence decisions.  A high score on the checklist did not rule out incompetence; written comments on “not competent” performances with high checklist scores included notations such as “significant breaches of sterility”, “laceration or damage of important structures”, and “unsuccessful or too many attempts” — Laura Willett, MD.

Walzak A, Bacchus M, Schaefer JP, Zarnke K, Glow J, Brass C, McLaughlin K, Ma IW. Diagnosing Technical Competence in Six Bedside Procedures: Comparing Checklists and a Global Rating Scale in the Assessment of Resident Performance. Acad Med. 2015 Apr 15.

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