Medical Education History
The objective structured clinical examination (OSCE) the true origins
This paper traces the true origins of the Objective Structured Clinical Examination (OSCE), a globally recognized assessment method introduced in 1979. It highlights the concerns regarding objectivity, validity, and reliability of prior clinical assessments. The OSCE emerged from a combination of the 'Steeplechase' examination method, a joint paper from the Universities of Dundee and Glasgow, and a dissertation by the author. The paper details the evidence-based narrative of its Irish connections and its development in Dundee prior to its 1979 publication debut.
Revolutionizing Clinical Assessment: The OSCE's Foundational Impact
The Objective Structured Clinical Examination (OSCE), born in 1979, transformed medical education by addressing critical flaws in traditional clinical assessments. Its roots lie in the 'Steeplechase' method, academic collaboration between Dundee and Glasgow, and a dedicated dissertation. This framework significantly enhanced objectivity, validity, and reliability, fostering a more equitable and robust evaluation of clinical competence. The OSCE's rapid global adoption underscores its profound and lasting influence on medical training and professional standards.
1979
OSCE Introduction Year
3,200
Related PubMed Publications
42%
Improved Pass Rate (MRCPI) for OSCE course participants
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Medical Education History
Steeplechase
Precursor to OSCE, emphasizing standardized assessment.
Evolution of the OSCE
1963: Author's Medical Studies Begin (RCSI)
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1965: Encounter with 'Steeplechase' Exam
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1973: Tutor/Registrar in Medicine, Organized MRCP Exams
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1975: Appointed Lecturer in Medical Education (Dundee); Ronald Harden's 'Objective Structured Examination' report
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1975-1977: Diploma in Educational Technology, Dissertation on 'Assessment of Clinical Competence'
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Concept of 'Objective' included, acronym OSCE coined
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1977: First OSCE deployed in surgery finals (Dundee)
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1979: OSCE publication debut
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OSCE Implementation at RCSI & JCMH, Dublin
Following its introduction, the OSCE was rapidly adopted in Ireland. Dr. Gleeson introduced the OSCE at the Royal College of Surgeons in Ireland (RCSI) and as undergraduate and postgraduate Dean at James Connolly Memorial Hospital (JCMH), Dublin. During the 1980s, two OSCEs replaced traditional short cases in Part 2 MRCPI (training) courses, contributing to an improved pass rate of 42% for course participants. The Objective Structured Long Examination Record (OSLER) was also introduced as an alternative to the long case, emphasizing immediate feedback and comprehensive clinical skills assessment.
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