Development of an objective structured clinical examination for assessment of clinical skills in an emergency medicine clerkship

Background: Assessment of medical students at the completion of their emergency medicine clerkship is wrought with issues-patient acuity, varied teaching styles and the unpredictable nature of the emergency department. Objective structured clinical examinations have been proven to serve as a valuable tool in medical education and other health professions. However, there have been limited publications regarding use of this assessment modality in undergraduate medical education in the field of Emergency Medicine (EM). Objectives: Development of an OSCE was undertaken in an effort to improve our ability to accurately assess the ability of clerkship students to independently manage patients with critical illness. Curricular Design: The EM clerkship OSCE consists of three cases with checklist items and key concepts that highlight the EM patient care milestones. Each case is 10 minutes in length, with 2 additional minutes allowed for feedback from faculty members. The students are graded using checklists completed by observing faculty members and standardized patients. Impact/Effectiveness: Performance data of 80 students was analyzed with each individual checklist item being assessed for difficulty(percentage correct) and discrimination(rpb). The information from the data analysis was then utilized to adjust the examination checklist and enhance our curriculum. Establishment of an OSCE has provided us with important information regarding both our student assessment and our clerkship curriculum.