-
Examiner seniority and experience are associated with bias when scoring communication, but not examination, skills in objective structured clinical examinations in Australia
-
Lauren Chong, Silas Taylor, Matthew Haywood, Barbara-Ann Adelstein, Boaz Shulruf
-
J Educ Eval Health Prof. 2018;15:17.
-
DOI: https://doi.org/10.3352/jeehp.2018.15.17
-
-
25,438
View
-
278
Download
-
19
Web of Science
-
17
Crossref
-
Abstract
PDFSupplementary Material
- Purpose
The biases that may influence objective structured clinical examination (OSCE) scoring are well understood, and recent research has attempted to establish the magnitude of their impact. However, the influence of examiner experience, clinical seniority, and occupation on communication and physical examination scores in OSCEs has not yet been clearly established.
Methods We compared the mean scores awarded for generic and clinical communication and physical examination skills in 2 undergraduate medicine OSCEs in relation to examiner characteristics (gender, examining experience, occupation, seniority, and speciality). The statistical significance of the differences was calculated using the 2-tailed independent t-test and analysis of variance.
Results Five hundred and seventeen students were examined by 237 examiners at the University of New South Wales in 2014 and 2016. Examiner gender, occupation (academic, clinician, or clinical tutor), and job type (specialist or generalist) did not significantly impact scores. Junior doctors gave consistently higher scores than senior doctors in all domains, and this difference was statistically significant for generic and clinical communication scores. Examiner experience was significantly inversely correlated with generic communication scores.
Conclusion We suggest that the assessment of examination skills may be less susceptible to bias because this process is fairly prescriptive, affording greater scoring objectivity. We recommend training to define the marking criteria, teaching curriculum, and expected level of performance in communication skills to reduce bias in OSCE assessment.
-
Citations
Citations to this article as recorded by
- Analyse systématique des évaluations de circuits multiples d’examen clinique objectif structuré (ECOS) : variables explicatives et corrélations inter-évaluateurs
E. Ollier, C. Pelissier, C. Boissier, T. Barjat, P. Berthelot, C. Boutet, X. Gocko, C. Le Hello, S. Perinel La Revue de Médecine Interne.2024;[Epub] CrossRef - Association entre les performances cliniques des étudiants et leur réussite aux Épreuves classantes nationales informatisées : une étude de cohorte rétrospective monocentrique
L. Azoyan, Y. Lombardi, M.C. Renaud, A. Duguet, S. Georgin-Lavialle, F. Cohen-Aubart, G. Ibanez, O. Steichen La Revue de Médecine Interne.2023; 44(1): 5. CrossRef - Bias in Medical School Clerkship Grading: Is It Time for a Change?
Rachel A. Russo, Dana M. Raml, Anna J. Kerlek, Martin Klapheke, Katherine B. Martin, Jeffrey J. Rakofsky Academic Psychiatry.2023; 47(4): 428. CrossRef - Are we ready yet for digital transformation? Virtual versus on-campus OSCE as assessment tools in pharmacy education. A randomized controlled head-to-head comparative assessment
Zelal Kharaba, Mohammad M. AlAhmad, Asim Ahmed Elnour, Abdallah Abou Hajal, Suhad Abumweis, Mohammad A. Ghattas Saudi Pharmaceutical Journal.2023; 31(3): 359. CrossRef - Comparing Entrustable Professional Activity Scores Given by Faculty Physicians and Senior Trainees to First-Year Residents
Steven J Katz, Dennis Wang Cureus.2022;[Epub] CrossRef - eOSCE stations live versus remote evaluation and scores variability
Donia Bouzid, Jimmy Mullaert, Aiham Ghazali, Valentine Marie Ferré, France Mentré, Cédric Lemogne, Philippe Ruszniewski, Albert Faye, Alexy Tran Dinh, Tristan Mirault, Nathan Peiffer Smadja, Léonore Muller, Laure Falque Pierrotin, Michael Thy, Maksud Assa BMC Medical Education.2022;[Epub] CrossRef - Development and Evaluation of an Online Exam for Exercise Physiology During the COVID-19 Pandemic
Amanda L Burdett, Nancy van Doorn, Matthew D Jones, Natalie CG Kwai, Rachel E Ward, Silas Taylor, Boaz Shulruf Journal of Clinical Exercise Physiology.2022; 11(4): 122. CrossRef - Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study
Ying-Ying Yang, Pin-Hsiang Huang, Ling-Yu Yang, Chia-Chang Huang, Chih-Wei Liu, Shiau-Shian Huang, Chen-Huan Chen, Fa-Yauh Lee, Shou-Yen Kao, Boaz Shulruf Journal of Educational Evaluation for Health Professions.2022; 19: 27. CrossRef - How biased are you? The effect of prior performance information on attending physician ratings and implications for learner handover
Tammy Shaw, Timothy J. Wood, Claire Touchie, Debra Pugh, Susan M. Humphrey-Murto Advances in Health Sciences Education.2021; 26(1): 199. CrossRef - Does objective structured clinical examination examiners’ backgrounds influence the score agreement?
Oscar Gilang Purnajati, Rachmadya Nur Hidayah, Gandes Retno Rahayu The Asia Pacific Scholar.2021; 6(2): 48. CrossRef - Ethnic and gender bias in objective structured clinical examination: A critical review
IrisC. I. Chao, Efrem Violato, Brendan Concannon, Charlotte McCartan, Sharla King, MaryRoduta Roberts Education in the Health Professions.2021; 4(2): 37. CrossRef - Tutor–Student Partnership in Practice OSCE to Enhance Medical Education
Eve Cosker, Valentin Favier, Patrice Gallet, Francis Raphael, Emmanuelle Moussier, Louise Tyvaert, Marc Braun, Eva Feigerlova Medical Science Educator.2021; 31(6): 1803. CrossRef - Empirical analysis comparing the tele-objective structured clinical examination and the in-person assessment in Australia
Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen Journal of Educational Evaluation for Health Professions.2021; 18: 23. CrossRef - Assessment methods and the validity and reliability of measurement tools in online objective structured clinical examinations: a systematic scoping review
Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen Journal of Educational Evaluation for Health Professions.2021; 18: 11. CrossRef - Is There Variability in Scoring of Student Surgical OSCE Performance Based on Examiner Experience and Expertise?
Claire L. Donohoe, Frank Reilly, Suzanne Donnelly, Ronan A. Cahill Journal of Surgical Education.2020; 77(5): 1202. CrossRef - The role of training in student examiner rating performance in a student-led mock OSCE
Jian Hui Koo, Kim Yao Ong, Yun Ting Yap, Kum Ying Tham Perspectives on Medical Education.2020; 10(5): 293. CrossRef - Insights into student assessment outcomes in rural clinical campuses
Boaz Shulruf, Gary Velan, Lesley Forster, Anthony O’Sullivan, Peter Harris, Silas Taylor BMC Medical Education.2019;[Epub] CrossRef
-
The sights and insights of examiners in objective structured clinical examinations
-
Lauren Chong, Silas Taylor, Matthew Haywood, Barbara-Ann Adelstein, Boaz Shulruf
-
J Educ Eval Health Prof. 2017;14:34. Published online December 27, 2017
-
DOI: https://doi.org/10.3352/jeehp.2017.14.34
-
-
31,271
View
-
398
Download
-
33
Web of Science
-
32
Crossref
-
Abstract
PDFSupplementary Material
- Purpose
The objective structured clinical examination (OSCE) is considered to be one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners’ assessment scores are influenced by several factors that may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners’ assessments.
Methods We performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed, with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area.
Results OSCE examiners’ assessment scores are influenced by factors belonging to 4 different domains: examination context, examinee characteristics, examinee-examiner interactions, and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects; the examiner’s gender and ethnicity; training; lifetime experience in assessing; leadership and familiarity with students; station type; and site effects.
Conclusion Several factors may influence the presumed objectivity of examiners’ assessments, and these factors need to be addressed to ensure the objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.
-
Citations
Citations to this article as recorded by
- Objective structured clinical examination for teaching and assessment: Evidence-based critique
Pooja Dewan, Sumaira Khalil, Piyush Gupta Clinical Epidemiology and Global Health.2024; 25: 101477. CrossRef - A Look at Demographics and Transition to Virtual Assessments: An Analysis of Bias in the American Board of Surgery General Surgery Certifying Exams
Beatriz Ibáñez, Andrew T. Jones, D. Rohan Jeyarajah, Daniel L. Dent, Caroline Prendergast, Carol L. Barry Journal of Surgical Education.2024; 81(4): 578. CrossRef - Educational guidelines for diversity and inclusion: addressing racism and eliminating biases in medical education
Samantha D. Buery-Joyner, Laura Baecher-Lind, Camille A. Clare, B. Star Hampton, Michael D. Moxley, Dotun Ogunyemi, Archana A. Pradhan, Shireen M. Madani Sims, Sara Whetstone, Mark B. Woodland, Nadine T. Katz American Journal of Obstetrics and Gynecology.2023; 228(2): 133. CrossRef - Quality Management of Objective Structured Clinical Examinations at a Multicampus Nursing College: A Pilot Study
Thandolwakhe Nyangeni, Dalena R.M. van Rooyen, Wilma ten Ham-Baloyi Journal of Nursing Education.2023; 62(3): 155. CrossRef - Scoring consistency of standard patients and examiners in the developed dental objective structured clinical examination system
Feng Zhu, Li Wu, Xiuxiu Shao, Lijuan Huang, Xiangfeng Meng, Rongrong Nie BMC Medical Education.2023;[Epub] CrossRef - Assessing the utility of a novel entrustment‐supervision assessment tool
Sebastian Dewhirst, Timothy J. Wood, Warren J. Cheung, Jason R. Frank Medical Education.2023;[Epub] CrossRef - Pre-COVID and COVID experience of objective structured clinical examination as a learning tool for post-graduate residents in Obstetrics & Gynecology-a quality improvement study
Charu Sharma, Pratibha Singh, Shashank Shekhar, Abhishek Bhardwaj, Manisha Jhirwal, Navdeep Kaur Ghuman, Meenakshi Gothwal, Garima Yadav, Priyanka Kathuria, Vibha Mishra Obstetrics & Gynecology Science.2023; 66(4): 316. CrossRef - Does following an “excellent” candidate in the objective structured clinical examination affect your checklist score?
Craig Brown, Mintu Nath, Wendy Watson, Mary Joan Macleod Journal of Applied Research in Higher Education.2023;[Epub] CrossRef - Interactions between the sex of the clinician grader and the sex of the chiropractic student intern on spinal manipulation assessment grade
Michael Sheppard, Stephanie Johnson, Victor Quiroz, John Ward Journal of Chiropractic Education.2023; 37(2): 157. CrossRef - PERCEPTION OF MEDICAL STUDENTS AND EXAMINERS TOWARDS OBJECTIVE STRUCTURED CLINICAL EXAMINATION: A FEEDBACK FOR IMPROVEMENT
Rozhan Sediq, Jamal Salih, Fattah Fattah, Adnan Hassan JOURNAL OF SULAIMANI MEDICAL COLLEGE.2023; 13(1): 57. CrossRef - Response to: Twelve tips for conducting a virtual OSCE
Mohamed Guled, Juned Islam, Haseeb Qureshi Medical Teacher.2022; 44(1): 101. CrossRef - Comparison of OSCE performance between 6- and 7-year medical school curricula in Taiwan
Jr-Wei Wu, Hao-Min Cheng, Shiau-Shian Huang, Jen-Feng Liang, Chia-Chang Huang, Ling-Yu Yang, Boaz Shulruf, Ying-Ying Yang, Chen-Huan Chen, Ming-Chih Hou, Wayne Huey-Herng Sheu BMC Medical Education.2022;[Epub] CrossRef - Factors Associated With Undergraduate Nursing Students' Academic and Clinical Performance: A Mixed-Methods Study
Ensieh Fooladi, Md Nazmul Karim, Sheila Vance, Lorraine Walker, Maya Ebrahimi Zanjani, Dragan Ilic, Gabrielle Brand Frontiers in Medicine.2022;[Epub] CrossRef - Medical Students’ Perception of a Newly Implemented Objective Structured Clinical Examination (OSCE) in Orthopedic Surgery and Trauma: A Mixed-Method Study
Asser Sallam, Hani Atwa, Adel Abdelaziz, Asmaa Abdel Nasser Journal of Ecophysiology and Occupational Health.2022; 22(1): 29. CrossRef - Using Think-aloud Interviews to Examine a Clinically Oriented Performance Assessment Rubric
Mary Roduta Roberts, Chad M. Gotch, Megan Cook, Karin Werther, Iris C. I. Chao Measurement: Interdisciplinary Research and Perspectives.2022; 20(3): 139. CrossRef - Objective structured clinical examination: Challenges and opportunities from students’ perspective
Nazdar Alkhateeb, Abubakir Majeed Salih, Nazar Shabila, Ali Al-Dabbagh, Ayse Hilal Bati PLOS ONE.2022; 17(9): e0274055. CrossRef - Medical school grades may predict future clinical competence
Jr-Wei Wu, Hao-Min Cheng, Shiau-Shian Huang, Jen-Feng Liang, Chia-Chang Huang, Boaz Shulruf, Ying-Ying Yang, Chen-Huan Chen, Ming-Chih Hou, Wayne Huey-Herng Sheu Journal of the Chinese Medical Association.2022; 85(9): 909. CrossRef - Development and Evaluation of an Online Exam for Exercise Physiology During the COVID-19 Pandemic
Amanda L Burdett, Nancy van Doorn, Matthew D Jones, Natalie CG Kwai, Rachel E Ward, Silas Taylor, Boaz Shulruf Journal of Clinical Exercise Physiology.2022; 11(4): 122. CrossRef - eOSCE stations live versus remote evaluation and scores variability
Donia Bouzid, Jimmy Mullaert, Aiham Ghazali, Valentine Marie Ferré, France Mentré, Cédric Lemogne, Philippe Ruszniewski, Albert Faye, Alexy Tran Dinh, Tristan Mirault, Nathan Peiffer Smadja, Léonore Muller, Laure Falque Pierrotin, Michael Thy, Maksud Assa BMC Medical Education.2022;[Epub] CrossRef - Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study
Ying-Ying Yang, Pin-Hsiang Huang, Ling-Yu Yang, Chia-Chang Huang, Chih-Wei Liu, Shiau-Shian Huang, Chen-Huan Chen, Fa-Yauh Lee, Shou-Yen Kao, Boaz Shulruf Journal of Educational Evaluation for Health Professions.2022; 19: 27. CrossRef - Augmenting physician examiner scoring in objective structured clinical examinations: including the standardized patient perspective
Marguerite Roy, Josée Wojcik, Ilona Bartman, Sydney Smee Advances in Health Sciences Education.2021; 26(1): 313. CrossRef - Re-conceptualising and accounting for examiner (cut-score) stringency in a ‘high frequency, small cohort’ performance test
Matt Homer Advances in Health Sciences Education.2021; 26(2): 369. CrossRef - Comparison of the validity of bookmark and Angoff standard setting methods in medical performance tests
Majid Yousefi Afrashteh BMC Medical Education.2021;[Epub] CrossRef - Examiners’ decision‐making processes in observation‐based clinical examinations
Bunmi S. Malau‐Aduli, Richard B. Hays, Karen D’Souza, Amy M. Smith, Karina Jones, Richard Turner, Lizzi Shires, Jane Smith, Shannon Saad, Cassandra Richmond, Antonio Celenza, Tarun Sen Gupta Medical Education.2021; 55(3): 344. CrossRef - Tutor–Student Partnership in Practice OSCE to Enhance Medical Education
Eve Cosker, Valentin Favier, Patrice Gallet, Francis Raphael, Emmanuelle Moussier, Louise Tyvaert, Marc Braun, Eva Feigerlova Medical Science Educator.2021; 31(6): 1803. CrossRef - Perception of Students and Examiners about Objective Structured Clinical Examination in a Teaching Hospital in Ethiopia
Henok Fisseha, Hailemichael Desalegn Advances in Medical Education and Practice.2021; Volume 12: 1439. CrossRef - The Impact of COVID-19 Pandemic on the Learning Outcomes of Medical Students in Taiwan: A Two-Year Prospective Cohort Study of OSCE Performance
Tzyy-Yurn Tzeng, Chia-An Hsu, Ying-Ying Yang, Eunice J. Yuan, Ya-Ting Chang, Tzu-Hao Li, Chung-Pin Li, Jen-Feng Liang, Jiing-Feng Lirng, Tzeng-Ji Chen, Chia-Chang Huang, Ming-Chih Hou, Chen-Huan Chen, Wayne Huey-Herng Sheu International Journal of Environmental Research and Public Health.2021; 19(1): 208. CrossRef - Assessment methods and the validity and reliability of measurement tools in online objective structured clinical examinations: a systematic scoping review
Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen Journal of Educational Evaluation for Health Professions.2021; 18: 11. CrossRef - Versatility in multiple mini-interview implementation: Rater background does not significantly influence assessment scoring
Keith D. Baker, Roy T. Sabo, Meagan Rawls, Moshe Feldman, Sally A. Santen Medical Teacher.2020; 42(4): 411. CrossRef - Qualifying online assessment during COVID-19 pandemic: Reflecting on our experience under the cognitive lens of Miller’s pyramid
Dinesh Kumar, Rajasekhar Sajja SN Research and Development in Medical Education.2020; 9(1): 15. CrossRef - Comparison of the effects of simulated patient clinical skill training and student roleplay on objective structured clinical examination performance among medical students in Australia
Silas Taylor, Matthew Haywood, Boaz Shulruf Journal of Educational Evaluation for Health Professions.2019; 16: 3. CrossRef - Insights into student assessment outcomes in rural clinical campuses
Boaz Shulruf, Gary Velan, Lesley Forster, Anthony O’Sullivan, Peter Harris, Silas Taylor BMC Medical Education.2019;[Epub] CrossRef
|