13.   Disadvantages of OSCE


I seldom think of my limitations, and they never make me sad.

Perhaps there is just a touch of yearning at times;

but it is vague, like a breeze among flowers.

Helen Keller

Contents:

Homepage - OSCE and OSPE

Compiled Responses

 The Beginning

 01.   Introduction and Basics of OSPE/OSCE

 02.   Is OSPE glorified spotting.. 

  03.   How to set up OSCE and OSPE stations..

 04.   How to collect the answer-sheets in OSCE/OSPE from students.

 05.   OSCE reliability

 06.   Levels of competencies in evaluation

 07.   Practical experiences of OSPE/OSCE

 08.   OSCE in testing Communication and attitudes

  09   Should knowledge be accessed in OSCE/OSPE

 10.   Simulated patients

 11. Examiner training...a must to do...

12.   Standard setting in OSCE

 13.   Disadvantages of OSCE

 

Disadvantages of OSCE

Praveen: I am sorry that I had been busy for last few days due to certain unavoidable committments at both personal & Institutional level.
Adding to a very nice ongoing  nice discussion can we discuss some of the disadvantages of OSCE which are very few & we will mainly concentrate on how they could be rectified for better implementation.
Some of them are :

1) Its very resource intensive.
2) Long time planning is required
3) External examiners need to be convinced/ (trained will be more appropriate) for the process.
4) Chances of leaking the stations if large no of observers (who may be intern/residents)
5) Proper look up for routine entries like roll. no. etc.
6) Examines in components, not holistic
7) Observer fatigue

 I am herewith sending an article " Critique on OSCE" complimenting our topic.

   Barmen A. Critiques of Objective structured clinical examination. Ann Acad Med Singapore 2005;34:478-82< xml="true" ns="urn:schemas-microsoft-com:office:office" prefix="o" namespace="">


Anupama: Some problems with OSPE in Pharmacology can be:
1. Time constraint
2. Logistical problems
3. Maintaining uniform difficulty levels
4. Shortage of observers
5. Observer fatigue
6. Time consuming

Sita: As we are discussing the disadvantages of OSCE, here is an article which highlights the importance of a well made checklist. The effectiveness of OSCE depends on the reliability of the checklist More list items does not necessarily result in better examination, since greater the number of items increases the chance of poor reliability and validity

Suhattaya B, Polpun B, Duenpen H  Sirirat T Piyaporn B Reliability of a Peer Checklist for Performance Setting Spinal Anesthesia and Bird’s Ventilator: Objective, Structured Clinical Examination (OSCE)


Anupama Sukhlecha: In OSCE, Some drawbacks can be: there is risk of observer fatigue if the observer has to record the performance of several candidates on lengthy check lists. All stations must invariably demand only equal time. Ensuring this, therefore, requires careful organization. Also, it is considered by many that breaking clinical skills into individual competencies is artificial and not meaningful.
 Reference:
 http://www.jpgmonline.com/....nanthakrishnan

Dr Tejinder Singh: Agreed - but OSCE is thought of as the most low expertise method of
all.
Moral: Any good assessment requires time, effort, people and money. It should not be seen as just happening.


Praveen : Moral will be well taken by all of us. We will definitely give our 100% effort on all the factors at hand and will not make it just an event.
We will take the listed disadvantages as challenge so that they can be removed/adjusted/minimized, to make it the process best from our side.
Combining OSCE with other methods like long case or viva improves reliability by increasing the sample of competencies and skills, taking care of content specificity.

Suman Singh: As very rightly mentioned by our learned teachers and now experienced by most of us, learning by students is directed by the method of assessment and for effective learning we need to give enough time to the process of evaluation and most of the limitations mentioned by Praveen are necessary for achieving the purpose for which evaluation is targeted. So in my views if we need to do justice to the learning process we should be ready to spare time and resources with proper planning.

Other limiting factors like proper entries by the students, problem of leaking the stations are inherent in all the methods.

OSCE must always be one of the components of evaluation process so that problems like non-holistic judgment do not arise.

If we introduce the method gradually training of both the internal and external faculty would not create problems.

Can we overcome Observers fatigue by giving them small breaks or rotate the stations so as to break the monotony?
But these all are just thoughts. Practical experience will make us learn to overcome the limitations and best way to handle them.

Praveen: Yes, you are right, observer fatigue can be done with small breaks or making two set of observers which can be changed after two rounds of OSCE.
To make it holistic, yes you are again right we can for different methods together eg. Combine long case with OSCE. Or some similar approach where we can test in a holistic approach by combining with one of the traditional approach at least to begin with so that we can have more of objectivity introduced in it.

Praveen: As of now we can see that most of the concepts of OSCE/OSPE stand clear, still if there is any query/inquisitiveness/difficult concept, we can discuss it over here.
Can we take advantage of this to clear our doubts?

 

 

 

Discussion Summary

Introduction

Origin and evolution of OSCE

What is OSCE OSPE..

Important terminologies OSCE and OSPE

Process - OSCE and OSPE

Competencies

Advantages OSCE and OSPE

Limitation OSCE and OSPE

The final words