OSCEs for Undergraduate Clinical Examination in Orthopaedics: Inter-Examiner Variability
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Date
2016
Authors
Ndeleva, B.M.
Journal Title
Journal ISSN
Volume Title
Publisher
AJOL
Abstract
Background: The traditional clinical examination has fallen into disfavour on account of considerable
inter-examiner variability. The OSCE is gaining popularity as it is perceived to be less prone to this.
Objective: To establish whether inter-examiner variability is still a significant factor for the undergraduate
orthopaedic clinical examination in our institution.
Method: Thirty three final year students were randomly divided into two groups of 17 and 16 students.
Two standardized OSCE questions were administered to each student by four examiners with each group
being examined by one lecturer for each of the questions. For the first question, students in Group 1 were
examined by Examiner A while those in Group 2 were examined by Examiner B. For the second question,
students in Group 1 were examined by Examiner C while those in Group 2 were examined by Examiner
D. The scores for each student were tabulated and the range, mean, and pass rate determined for each of
the examiners. The Student’s t-test was calculated to determine if there was statistically significant interexaminer
variability.
Results: For Question 1, the mean score for students examined by Examiner A (Group 1) was 7.47 marks
while that for Examiner B (Group 2) was 5.59 marks. The p-value was 0.01367 (95% confidence interval). For
Question 2, the mean score for students examined by Examiner C (Group 1) was 7.32 marks while that for
Examiner D (Group 2) was 8.625. The p-value was 0.001148 (95% confidence interval).
Conclusion: There was statistically significant inter-examiner variability. We recommend that for all OSCE
exams, examiners be paired with a deliberate attempt to pair a “Hawk” with a “Dove”. Statistical correction
of biases is also recommended
Description
Research Article
Keywords
Citation
EAOJ; Vol. 10: September 2016