A COMPARISON OF THE OBJECTIVE STRUCTURED CLINICAL EXAMINATION AND THE TRADITIONAL ORAL CLINICAL EXAMINATION IN A NIGERIAN UNIVERSITY

1Tijani KH*, 1Giwa SO, 2Abiola AO, 1Adesanya AA , 1Nwawolo CC, 3Hassan JO.

1Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria.

2Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.

3Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria.

*Correspondence
Grant support: None
Conflict of interest: None

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ABSTRACT

Background:Assessment of clinical skills is essential in medical education. Ideally marks should be based on the student’s competence alone. The limitations of the traditional long case examinations such as the patient and examiner variability are well known. The objective structured clinical examination (OSCE) was designed to overcome these limitations. Studies comparing the OSCE and the traditional long case examination in the same group of students are very sparse.

Aim: To compare the objective structured clinical examination (OSCE) and the traditional long case examination by determining their correlations with other forms of assessment in undergraduate surgery.

Setting: This study was carried out at the College of Medicine, University of Lagos, Nigeria.

Methodology: The results of 612 undergraduate students in our medical school of the University of Lagos, Nigeria over a period of 4 years (2012-2015) were analysed. The scores in the long case examination , objective structured clinical examination (OSCE) , multiple choice questions and Essays were analysed and compared using the Pearson’s Correlation co-efficient. SPSS version 17 software was used and a P-value < 0.01 was regarded as statistically significant.

Results: Overall, there was a statistical significant positive correlation among most forms of assessment. The OSCE and the long case examination had a correlation of 0.374. Compared with the long case examination, the OSCE had a higher correlation with all other forms of assessment. The total clinical score (the sum of all long case examination and OSCE) however performed better than the OSCE or the long case examination alone as it had the highest correlation with all other forms of assessment.

Conclusion: The OSCE has been shown to be better than the long case examination as an indicator of the student overall knowledge of surgery as it had a superior correlation with other forms of assessments. The total clinical score was however the best indicator of the student overall knowledge in Surgery as it had the best correlation with other forms of assessment. We recommend and encourage institutions that presently combine the OSCE and the long case examination to carry out similar analysis such as ours to determine the desirability of combining LCE and OSCE rather than outright replacement of LCE with OSCE.

Key words: Objective structured clinical examination, OSCE, Traditional oral clinical examination, Long case examination, Nigeria.

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