Objective Structured

Clinical Examination
General Principles

Faculty of Medicine, Universitas Padjadjaran

 Introduction :
• Assessing clinical competence of doctor is an important
International agenda
 What is OSCE ?
• OSCE aims at testing the knowledge,
psychomotor skills, attitudes, as well as
communication skills

• It tests the each component of clinical

competence uniformly & objectively when the
students take up particular examination
 Definition
• Objective
Each student is graded by the same checklist
comprised of behaviorally measurable criteria.

• Structured
Each student has the same tasks and the same time to
complete those tasks. Each patient is trained to role-play
identical symptoms in a standard fashion.
 Definition
• Clinical
Clinical skills are measured, reflecting a practitioner’s ability to take a
relevant history, conduct a focused physical examination, and provide
appropriate counseling to a patient.

• Examination
It is a test.

Harden RG and Gleeson FA Assessment of clinical competence using an objective structured clinical
examination (OSCE) Medical Education,1979, Vol 13: 41-54
 Station 1 Station 2 Station 3 Station 4

Rest station

Interstation

Station 8 Station 7 Station 6 Station 5

 REQUIEREMENT
• Eligible
• Full Skill’s lab Attendance (100%)
• Registered by SBP
 OSCE in Clinical
Clerkship
• 12 stations @ 15 minutes with standardized patient
• Aspect to be evaluated:
o Introduction
o Anamnesis
o Physical examination
o Diagnosis/differential diagnosis
o Planning of Management/laboratory examination
o Professionalism
o Communication skills
 Examiner Check List
• OSCE
• Case : A man 65 years old come to your
clinic, with chief complain of difficulty in
micturation. He also complains of
frequency, nocturia 3-4x/night, weak
stream, and incomplete emptying.
• You have to perform DRE.
• Please perform DRE on this patient!
 Examiner Check List
NO. Procedure Performance Scale Comment

0 1 2
1. Ask the patient that he has been informed about
DRE.
2. Ask the patient to take off his underwear.

3. Help the patient to lay on the bad and in the

correct position for DRE.
4. Cover the patient from abdomen to his thigh
with a blanket.

5. Use the penlight/stand lamp to lighten buttock

area.
6. Use the glove on your dominant hand.

7. Apply jelly to the index finger.

8. Assess patient position whether it is appropriate

or not.
 Examiner Check List
Note:
Performance Scale.
0 : Bad = if the student can not tell the procedure.
1 : Fair = if the student can tell the procedure but
incomplete.
2 : Good = if the student can tell the procedure
completely.

Score : 32 – 40 : Pass
< 32 : Fail
The day of the test
Student preparation: Isolation room
• Video : 6 : 00 – 6:56, 7:
05 – 7: 13
First step: Read the
instruction
• Video : 07:58 – 8: 50,
10: 30 – 10:50.
History Taking Station
• Video : 33:18 – 38:50,
39:15 – 40 : 37
Procedural skills station: Lab. skills
• Video : 10 : 54 – 17: 18
Rest Station
 Results ?
Fail Remediation Pass !
 Pass Mark ?

• Clinical procedural skills : 100 % (A)

• Physical examination : 100 % (A)
• History taking : 80 % (A)
• Interpretations : 80 % (A)
• Investigation : 80 % (A)
• Management : 80% (A)
 Final Scoring:
• Pass:
o Mean score of all stations ≥ 80%
o No stations with scores of < 80%
• Provisionally pass: (must attend remedial teach.)
o Mean score of all stations ≥ 80%
o No more than 6 stations with scores of < 80%
• Fail:
o Mean score >6 stations < 80%