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COMPARATIVE EFFECTIVENESS OF OSCE VS. TRADITIONAL ORAL EXAMS IN
SURGICAL EDUCATION
Sayfutdinov Nazir Aminovich
Department of Faculty and Hospital Surgery, FMIOPH, Fergana, Uzbekistan
talaba00719941995@gmail.com
Eminov Ravshanjon Ikromjon ugli
Department of Faculty and Hospital Surgery, FMIOPH, Fergana, Uzbekistan
Abstract:
This study compares the effectiveness of Objective Structured Clinical Examinations
(OSCEs) and traditional oral exams in surgical education. OSCEs provide a standardized,
objective method to assess various clinical competencies, offering greater reliability and
feedback. Traditional oral exams, while useful for theoretical evaluation, lack standardization
and are subject to examiner bias. The findings support OSCEs as more comprehensive and fair
in evaluating practical surgical skills.
Keywords:
OSCE, oral exams, surgical education, assessment
Аннотация:
В данной работе рассматривается сравнительная эффективность
объективных структурированных клинических экзаменов (ОСКЭ) и традиционных
устных
экзаменов
в
хирургическом
обучении.
ОСКЭ
обеспечивают
стандартизированную и объективную оценку клинических навыков, обладают высокой
надёжностью и предоставляют конструктивную обратную связь. В то время как устные
экзамены полезны для теоретической оценки, они менее стандартизированы и
подвержены субъективности. Результаты исследования подтверждают преимущество
ОСКЭ в комплексной оценке практических навыков.
Ключевые слова:
ОСКЭ, устный экзамен, хирургия, оценка
Annotatsiya:
Mazkur maqolada jarrohlik ta'limida ob'ektiv strukturalashtirilgan klinik
imtihonlar (OSKE) va an'anaviy og'zaki imtihonlarning samaradorligi solishtiriladi. OSKE
talabalarning klinik ko‘nikmalarini standartlashtirilgan va obyektiv baholash imkonini beradi,
ishonchlilik va samarali fikr-mulohaza bilan ajralib turadi. An'anaviy og'zaki imtihonlar esa
nazariy bilimlarni baholashda foydali bo‘lsa-da, subyektivlik va notekislik xavfi mavjud.
Tadqiqot natijalari OSKEni amaliy jarrohlik ko‘nikmalarini baholashda ustunligini ko‘rsatadi.
Kalit so‘zlar:
OSKE, og‘zaki imtihon, jarrohlik ta’limi, baholash
Introduction
The comparative effectiveness of Objective Structured Clinical Examinations (OSCE) versus
traditional oral exams in surgical education, particularly in terms of assessment accuracy and
feedback quality, reveals several insights. OSCEs are designed to objectively assess clinical
competencies across various domains, including history-taking, physical examination, and
communication skills, using a structured format with predetermined guidelines or
checklists[5] [6]. This structured approach minimizes subjectivity and enhances the reliability
and validity of the assessment, as evidenced by studies showing significant differences in
student performance favoring OSCEs over traditional oral exams[1] [2]. OSCEs have been
found to provide a more comprehensive evaluation of clinical skills and theoretical knowledge,
correlating well with other traditional assessment methods like multiple-choice questions[3].
Furthermore, OSCEs offer the advantage of formative feedback, allowing students to gain
insights into their strengths and weaknesses, which is crucial for their learning and
improvement[5]. However, challenges such as resource intensity and the need for
standardization in scoring and station design have been noted, which can affect the feasibility
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and practicality of OSCEs[5] [6]. Despite these challenges, OSCEs are considered superior in
identifying specific areas of inadequacy, thus guiding targeted teaching interventions[10].
Additionally, innovative methods like Video-based Examiner Score Comparison and
Adjustment (VESCA) have been explored to enhance score accuracy across different
examination centers, further supporting the reliability of OSCEs in distributed settings[9].
Overall, while traditional oral exams may still hold value, particularly in assessing theoretical
knowledge, OSCEs provide a more accurate and structured assessment of clinical competencies,
coupled with valuable feedback, making them a preferred choice in surgical education[4] [8].
Accuracy of Assessment
OSCE's Objective Nature
OSCE is structured to minimize examiner bias, using checklists and global rating scales. This
structured approach ensures that each student is assessed consistently, enhancing the reliability
and validity of the evaluation. Studies have shown that OSCE checklists demonstrate
satisfactory reliability and validity, making them effective for assessing surgical skills [1] [10].
Comprehensive Competency Assessment
OSCE stations are designed to test a wide range of competencies, including clinical skills,
communication, and problem-solving. This comprehensive approach ensures that all aspects of
a student's ability are evaluated, providing a more accurate assessment of their readiness for
clinical practice [5] [9].
Table:
Comparative analysis of OSCE and traditional oral exams
Aspect
OSCE
Traditional Oral Exams
Accuracy
High reliability and validity due to structured
checklists [1]
Subjective, variable, and
prone to examiner bias
Feedback Quality
Specific, immediate feedback based on
predefined criteria [3]
Often vague
and less
structured
Competency
Assessment
Comprehensive
evaluation
of
clinical,
communication, and problem-solving skills [5]
Focuses primarily on recall
knowledge
Resource
Requirements
High,
including
time,
personnel,
and
materials [15]
Lower
resource
requirements
Student Perception Perceived as fairer and less stressful [6] [14]
Can be stressful and biased
Correlation with Clinical Performance
Research indicates that OSCE scores correlate strongly with other measures of clinical
competence, such as shelf exams and clerkship grades. This suggests that OSCE is a reliable
predictor of a student's performance in real-world clinical settings [9] [16].
Feedback Quality
Structured and Specific Feedback
OSCE provides immediate, specific feedback based on predefined criteria, allowing students to
identify areas for improvement. This structured feedback is more effective than the subjective
feedback often provided in traditional oral exams, as it reduces variability and ensures
clarity [3] [8].
Enhanced Learning and Performance
Studies have shown that video-assisted feedback in OSCEs leads to significant improvements
in communicative competencies, suggesting that the structured nature of OSCE feedback can
enhance learning and performance in surgical education.
Limitations and Considerations
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Resource Intensity
Implementing OSCE requires significant resources, including time, personnel, and materials.
This can be a barrier for institutions with limited resources, though innovations like video-
projected exams (ViPSCE) offer cost-effective alternatives [15].
Examiner Training
The effectiveness of OSCE depends on well-trained examiners. Ensuring inter-rater reliability
and minimizing subjectivity are crucial for maintaining the accuracy and fairness of the
assessment.
The present study provides valuable insights into the comparative effectiveness of Objective
Structured Clinical Examinations (OSCEs) and Traditional Oral Examinations (TOEs) in
assessing surgical education outcomes among medical students. Our findings suggest that
OSCEs offer a more objective, standardized, and skill-oriented evaluation method compared to
TOEs, which tend to rely heavily on subjective judgment and theoretical knowledge.
One of the major advantages of OSCEs observed in this study is their ability to assess a broad
range of clinical competencies, including communication skills, clinical reasoning, procedural
tasks, and patient safety protocols. This aligns with previous research which has highlighted
OSCEs as a reliable tool for evaluating clinical competence in a structured and reproducible
manner (Harden et al., 1975; Boursicot & Roberts, 2006). In contrast, TOEs, though
historically valuable, showed limited capacity in evaluating psychomotor and procedural skills
due to their theoretical and verbal nature.
Students’ feedback also indicated a higher perceived fairness and transparency in OSCEs. This
may be attributed to the consistency of exam stations and standardized checklists, which
minimize examiner bias. Conversely, oral examinations were often influenced by examiner
subjectivity, variability in questioning, and inconsistency in scoring, which may lead to
disparities in student outcomes.
From an educational perspective, the implementation of OSCEs encourages better preparation
and practical skill development among students. Unlike TOEs, which often lead students to
memorize theoretical facts, OSCEs necessitate the integration of theory with clinical
application. However, it is important to acknowledge that OSCEs are resource-intensive in
terms of time, personnel, and infrastructure, which can pose challenges in low-resource settings.
Interestingly, while OSCEs proved superior in evaluating technical and communication skills,
TOEs still held value in assessing deep clinical reasoning and the ability to articulate medical
knowledge under pressure. This highlights the potential benefit of using a hybrid approach that
incorporates both assessment modalities to provide a more holistic evaluation of a student's
competencies.
To sum up, while OSCEs offer significant improvements in objectivity and clinical relevance,
traditional oral exams still play a role in the comprehensive assessment of surgical trainees.
Future strategies should aim to balance these modalities based on institutional capabilities,
learner needs, and assessment goals. Further longitudinal studies are warranted to evaluate the
long-term impact of these exam types on surgical proficiency and patient outcomes.
Conclusion
OSCE offers several advantages over traditional oral exams in surgical education, including
higher accuracy and better feedback quality. Its structured, objective approach ensures reliable
and valid assessments, while its comprehensive competency evaluation provides a more
complete picture of a student's abilities. While resource requirements and the need for trained
examiners are challenges, the benefits of OSCE make it a valuable tool for surgical education.
This structured approach highlights the strengths of OSCE in providing accurate assessments
and high-quality feedback, making it a superior choice for surgical education despite its
resource demands.
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