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Structured Assessments of Clinical Competence
Book chapter

Structured Assessments of Clinical Competence

Katharine A. M Boursicot, Trudie E Roberts and William P Burdick
Understanding Medical Education, pp 335-345
03 Dec 2018
DOI: https://doi.org/10.1002/9781119373780.ch23

Abstract

clinical competence clinical skills assessment long case formats objective structured clinical examinations objective structured long case examination record short case formats structured assessments unstructured observations work‐based learning methods
With the development of work‐based learning methods to assess clinical performance in a more authentic and naturalistic way, there is the potential for confusion over terminology. This chapter considers assessments of clinical competence to be measures of what doctors can do in controlled representations of professional practice, i.e. under examination conditions. A variety of formats for assessing clinical competence have been developed over the years. The chapter reviews the more 'classical' long case and short case formats, and also describes newer formats such as the OSCE and Objective Structured Long Case Examination Record (OSLER). The OSCE is an assessment format in which the candidates rotate sequentially around a series of structured cases located in 'stations', at each of which specific tasks have to be performed. OSCEs are more reliable than unstructured observations in four main ways: more consistent scoring, overall competence, increase in reliability, and multiple independent observations are collated.

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