A sequenced OSCE for licensure: administrative issues, results and myths.

In response to stakeholder demands for a more cost-effective clinical examination, the Medical Council of Canada adopted a sequenced format for the OSCE component of its licensure examination. The sequenced OSCE was administered in 1997 at 14 sites and assessed 1,796 test takers. The 10-station screening test had an alpha = 0.66 (M = 61.3%, SD = 4.7%). The fail rate of 1.7% for Canadian first-time takers was the lowest since 1992. Significant savings were realized despite costs incurred by the new format. The logistical problems that were encountered were largely due to the constraints of administering a multi-site OSCE. Although the sequenced format was cost effective and psychometrically acceptable, the response of many test takers and faculty members was negative. Consequently, it is the logistical and political lessons that may be the most generalizable.

Developing protocols for change in medical education : report of an informal consultation, Seattle, Washington, USA, 11-14 August 1992 / Charles Boelen ... [et al.]

Medical schools should respond to the health needs of society by reorienting the education of physicians to ensure that they possess the appropriate skills and are able to practise them. For medical education to become more relevant and efficient, changes must occur in curriculum content, learning processes and the relationship of medical schools with the health care system. This monograph offers guidelines for change in the form of steps for getting started, steps for development and early implementation, and steps for later adoption. A goal is set for each step, and specific tasks are suggested to help attain the goal; advice is offered on how to develop the tasks, and signs of progress are suggested. Also proposed are areas for future action, including action research, to improve the relevance and efficiency of medical education