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How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE)

  • Hamann, Claus1
  • Volkan, Kevin2
  • Fishman, Mary B3
  • Silvestri, Ronald C4
  • Simon, Steven R5
  • Fletcher, Suzanne W5
  • 1 Massachusetts General Hospital, Geriatric Medicine Unit, 100 Charles River Plaza, Fifth Floor, Boston, MA, USA , Boston (United States)
  • 2 California State University Channel Islands, Program in Psychology, Professional Building, University Drive, Camarillo, CA, 93012, USA , Camarillo (United States)
  • 3 Georgetown University Medical Center, Division of General Internal Medicine, 3800 Reservoir Rd. NW, Washington, DC, 20007, USA , Washington (United States)
  • 4 Beth Israel Deaconess Medical Center, Department of Medicine, 330 Brookline Ave, Boston, MA, 02215, USA , Boston (United States)
  • 5 Harvard Medical School and Harvard Pilgrim Health Care, Department of Ambulatory Care and Prevention, 133 Brookline Avenue, Sixth Floor, Boston, MA, 02215, USA , Boston (United States)
Published Article
BMC Medical Education
Springer (Biomed Central Ltd.)
Publication Date
Jan 10, 2002
DOI: 10.1186/1472-6920-2-1
Springer Nature


BackgroundLittle is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course.MethodsCross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students.ResultsAverage total OSCE score was 57% (range 39–75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p < .0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p < .0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p < .0001).ConclusionsStudents scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

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