Experiencia con el empleo del examen OSCE en el ciclo de evaluación de competencias clínicas de médicos que revalidan su título.

Resumen

Background: Our institution adopted the Objective Structured Clinical Evaluation (OSCE) format to assess clinical skills of International Medical Graduates (IMGs) aiming to practice in Chile. The OSCE has clear advantages over oral exams due to its objective and structured nature. Aim: To report our experience with OSCE. Material and methods: A team consisting of clinical specialists and medical educators with expertise in clinical simulation organized this OSCE cycle. IMGs were required to pass four clinical examinations (Internal Medicine, Surgery, Pediatrics and Obstetrics & Gynecology) where their respective general medical competences were evaluated. The latter were carefully selected from those issued by the Chilean Medical Evaluation policy-making body (EUNACOM). Each OSCE consisted of ten stations. Initially conceived to last five minutes each, they were afterwards expanded to seven minutes, after it was realized that most candidates had never been exposed to an OSCE examination before. A post-hoc analysis according to qualitative and psychometric quality criteria followed each OSCE. Results: The proportion of candidates passing the first two examinations of the cycle, were 65 and 75% respectively and reached 100% in the last ones. Lack of IMG familiarity with the OSCE system initially hampered their full expression of competencies. Extending the stations’ duration to seven minutes subsequently rectified this situation, as well as potential adverse impacts on the validity of results. Conclusions: This evaluative process, which entails important consequences for the community and the IMGs, requires a meticulous and coordinated planning and post-hoc quality control.