Recipient: 2013-2014 - Timothy J. Wood

Background and rationale:

Objective Structured Clinical Examinations (OSCEs) are commonly used to assess clinical skills. Despite their popularity, there is a concern that OSCE stations are too short to realistically simulate a patient encounter. In response, some researchers have advocated the use of long cases and/or lengthening stations. This may be problematic because evidence from rater-based studies suggest raters form impressions of people they are judging within seconds, and these impressions then influence subsequent ratings. What is unknown, is to what degree will this occur within an OSCE station and, once formed, can the influence be altered. The purpose of this study is to examine: 1) the accuracy of first impressions in the context of a “stable” performance 2) the ability of physician examiners to modify their ratings in the context of a changing performance.
The setting is an OSCE station designed to assess the physical examination skills of examinees.

Methods:

This study will use a correlational analysis. Physicians will view a series of seven videos of examinees performing a clinical task. For some videos, the performance of the examinee will change during the station, for some it will remain constant. Examiners will be asked to make a judgment of the examinees’ clinical abilities within the first 60 seconds, after which they will continue to score the examinee. The first impression rating will be compared to the final station score. Additional analyses will look to see the degree to which the first impression rating and the final score assigned by the examiner varies as a function of the change in the examinees’ performance.

Significance:

If it can be demonstrated that first impressions can change within the context of an OSCE station, or alternatively remain stable despite the performance of the examinee, the result will have an impact on a growing call to use longer OSCE stations on examinations.