Managing very small scale objective structured clinical examinations - can we ensure reliability of pass/fail decisions with low candidate numbers? A feasibility study of global score only decision making

Abstract

Background: This study assesses a change to pass/fail decision making from an Angoff method to one based on examiner global judgements in very small scale Objective Structured Clinical Examinations (OSCE). Approach: Data was collected from a Physician Associate OSCE in which two examiners marked each station one utilising a global rating based mark scheme and the other the original, Angoff based, mark scheme. Alternative global ratings were used to try and improve the judgement decision of examiners and checklists significantly reduced into a small number of broader domains. Examiners were also asked to provide some feedback on the new rating scales. Evaluation: Mann-Whitney U tests were used to evaluate the data. Overall there was fairly good correlation of candidate performance between the two methods. Some anomalies were found with the use of the word safe in the global ratings creating a killer station. Examiners had mixed views but most were positive about the change in approach. Implications: The initial results seem promising suggesting that global rating scales alone may be suitable to determine pass/fail decisions in very small scale OSCE with implications for all educators managing such assessments. We intend to keep the adjusted global rating scales.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics Committee of The University of Sheffield (UK) gave ethical approval for this work. Ref 032488

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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