Skip to main content
SpringerLink
Log in

The Psychiatry OSCE: A 20-Year Retrospective

  • IN DEPTH ARTICLE: Systematic Review
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Objective

Twenty years ago researchers at the University of Toronto launched the Psychiatry Skills Assessment Project (PSAP), a research program exploring Objective Structured Clinical Examinations (OSCEs) in psychiatry. Between 1994 and 2005 PSAP produced publications on the feasibility, reliability, validity, ethics, and practical concerns of OSCEs in psychiatry. The current review has two parts: a review of the state of the art of OSCEs in psychiatry 20 years after they were introduced and documentation of the impact of the PSAP research program.

Methods

A literature search identified all publications on OSCEs and psychiatry. Articles were coded thematically, and locations of agreement and controversies were identified. Bibliometric analysis identified citations of PSAP research papers, which were analyzed thematically.

Results

As of May 2013, there were 250 publications related to OSCEs in psychiatry (not including 10 PSAP papers), published in 29 different countries and ten languages. Prominent topics were the validity and acceptability of OSCEs and SPs, systems issues in adopting OSCEs in psychiatry, and the effects on learning. Eighty-eight percent of all publications cited PSAP work (300 citations). Citations were employed for four purposes: as evidence/justification (54 %); to frame replication research (14 %); to support adaptation of OSCEs in other countries and professions (15 %); and for debate (18 %).

Conclusions

Over the past 20 years, use of OSCEs has grown steadily in psychiatry, and several national certification organizations have adopted OSCEs. PSAP work, introduced two decades ago, continues to provide a scholarly foundation for psychometric, practical, and ethical issues of interest to this field.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Loschen EL. Using the objective structured clinical examination in a psychiatry residency. Acad Psychiatry. 1993;17:95–104.

    Article  CAS  PubMed  Google Scholar 

  2. Famuyiwa OO, Zachariah MP, Ilechukwu STC. The objective structured clinical exam in psychiatry. Med Educ. 1991;25:45–50.

    Article  CAS  PubMed  Google Scholar 

  3. Hodges B, Lofchy J. Evaluating psychiatry clinical clerks with a mini-objective structured clinical examination. Acad Psychiatry. 1997;21:219–25.

    Article  CAS  PubMed  Google Scholar 

  4. Robinson DJ. A training and examination program to prepare psychiatric residents for OSCE-style exams. Acad Psychiatry. 2009;33:331–4.

    Article  PubMed  Google Scholar 

  5. Thompson CM. Will the CASC stand the test? A review and critical evaluation of the new MRCPsych clinical examination. Psychiatrist. 2009;33:145–8.

    Google Scholar 

  6. Schowalter JE. Standardized patients: a future possibility? Am Board Psychiatry Neurol Newsl. 2001;7:3.

    Google Scholar 

  7. Taghva A, Mir-Sepassi GR, Zarghami M. A brief report on the implementation of an objective structured clinical examination (OSCE) in the 2006 Iranian Board of Psychiatry Examination. Iran J Psychiatry Behav Sci. 2007;1:39–40.

    Google Scholar 

  8. Al Sinawi H, Al Sharbati M, Obaid Y, et al. Preparing and conducting objective structured clinical examination for Oman medical specialty board R1–R4 residents. Oman Med J. 2012;27:246–8.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Hodges B, Regehr G, Hanson M, et al. The objective structured clinical examination for evaluating psychiatric clinical clerks. Acad Med. 1997;72:715–21.

    Article  CAS  PubMed  Google Scholar 

  10. Hodges B, Regehr G, Hanson M, et al. Validation of an objective structured clinical examination in psychiatry. Acad Med. 1998;73:910–2.

    Article  CAS  PubMed  Google Scholar 

  11. Hanson M, Hodges B, McNaughton N, et al. The integration of child psychiatry into a psychiatry clerkship OSCE. Can J Psychiatry. 1998;43:614–8.

    CAS  PubMed  Google Scholar 

  12. Hodges B, Hanson M, McNaughton N, et al. What do psychiatry residents think of an OSCE? Acad Psychiatry. 1999;23:198–204.

    Google Scholar 

  13. McNaughton N, Tiberius R, Hodges B. Effects of portraying psychologically and emotionally complex standardized patient roles. Teach Learn Med. 1999;11:135–41.

    Article  Google Scholar 

  14. Hanson M, Tiberius R, Hodges B, et al. Adolescent standardized patients: methods of selection and assessment of benefits and risks. Teach Learn Med. 2002;14:104–13.

    Article  PubMed  Google Scholar 

  15. Hanson M, Tiberius R, Hodges B, et al. Implications of suicide contagion for the selection of adolescent standardized patients. Acad Med. 2002;77:S100–2.

    Article  PubMed  Google Scholar 

  16. Hodges B, Hanson M, McNaughton N, et al. Creating, monitoring and improving a psychiatry OSCE: a guide for faculty. Acad Psychiatry. 2002;26:134–61.

    Article  PubMed  Google Scholar 

  17. Sauer J, Hodges B, Santhouse A, et al. The OSCE has landed: one small step for British psychiatry? Acad Psychiatry. 2005;29:310–5.

    Article  PubMed  Google Scholar 

  18. Barrows HS, Abrahamson S. The programmed patient: a technique for appraising student performance in clinical neurology. J Med Educ. 1964;39:802–5.

    CAS  PubMed  Google Scholar 

  19. Harden RM, Stevenson M, Downie WW, et al. Assessment of clinical competence using objective structured examinations. Br Med J. 1975;1:447–51.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Hodges BD. The objective structured clinical examination: a socio-history. Koln: LAP; 2009.

    Google Scholar 

  21. Park RS, Chibnall JT, Blaskiewicz RJ, et al. Construct validity of an objective structured clinical examination (OSCE) in psychiatry: associations with the clinical skills examination and other indicators. Acad Psychiatry. 2004;28:122–8.

    Article  PubMed  Google Scholar 

  22. Walters K, Osborn D, Raven P. The development, validity and reliability of a multimodality objective structured clinical examination in psychiatry. Med Educ. 2005;39:292–8.

    Article  CAS  PubMed  Google Scholar 

  23. Vaidya NA. Psychiatry clerkship objective structured clinical examination is here to stay. Acad Psychiatry. 2008;32:177–9.

    Article  PubMed  Google Scholar 

  24. Amr M, Amin T. Assessment methods of an undergraduate psychiatry course at a Saudi university. Sultan Qaboos Univ Med J. 2012;12:214–20.

    PubMed Central  PubMed  Google Scholar 

  25. Ismail WSW, ZamZam R, Jaafar NRN, et al. Objective structured clinical examination (OSCE) in psychiatry new curriculum undergraduate posting and its standard setting procedure: an experience in Universiti Kebangsaan Malaysia (Ukm). ASEAN J Psychiatry. 2010;11:118–27.

    Google Scholar 

  26. Benning T, Broadhurst M. The long case is dead—long live the long case loss of the Mrcpsych long case and holism in psychiatry. Psychiatrist. 2007;31:441–2.

    Google Scholar 

  27. Rasoulian M, Taghva A, Panaghi L, et al. A qualitative study of psychiatrists’ view about a pilot objective structured clinical examination (OSCE) in Iran. Iran J Psychiatry Behav Sci. 2007;1:27–9.

    Google Scholar 

  28. Marwaha S. Objective structured clinical examinations (OSCEs), psychiatry and the clinical assessment of skills and competencies (CASC) same evidence, different judgment. BMC Psychiatry. 2011;11:85.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Taghva A, Panaghi L, Rasoulian M, et al. Evaluation of reliability and validity of the psychiatry OSCE in Iran. Acad Psychiatry. 2010;34:154–7.

    Article  PubMed  Google Scholar 

  30. Yudkowsky R. Should we use standardized patients instead of real patients for high-stakes exams in psychiatry? Acad Psychiatry. 2002;26:187–92.

    Article  PubMed  Google Scholar 

  31. Taghva A, Bolhari J, Bahador H, et al. How to run psychiatry OSCE in three days. Iran J Psychiatry Behav Sci. 2008;2:5–9.

    Google Scholar 

  32. Ramchandani D. End of third-year objective structured clinical examination: boon or bane? Acad Psychiatry. 2008;32:173–6.

    Article  PubMed  Google Scholar 

  33. Birndorf CA, Kaye ME. Teaching the mental status examination to medical students by using a standardized patient in a large group setting. Acad Psychiatry. 2002;26:180–3.

    Article  PubMed  Google Scholar 

  34. Dave S. Simulation in psychiatric teaching. Adv Psychiatr Treat. 2012;18:292–8.

    Article  Google Scholar 

  35. Hall MJ, Adamo G, McCurry L, et al. Use of standardized patients to enhance a psychiatry clerkship. Acad Med. 2004;79:28–31.

    Article  PubMed  Google Scholar 

  36. Sadeghi M, Taghva A, Mirsepassi G, et al. How do examiners and examinees think about role-playing of standardized patients in an OSCE setting? Acad Psychiatry. 2007;31:358–62.

    Article  PubMed  Google Scholar 

  37. Brenner A. Uses and limitations of simulated patients in psychiatric education. Acad Psychiatry. 2009;33:112–9.

    Article  PubMed  Google Scholar 

  38. Krahn LE, Bostwick JM, Sutor B, et al. The challenge of empathy: a pilot study of the use of standardized patients to teach introductory psychopathology to medical students. Acad Psychiatry. 2002;26:26–30.

    Article  PubMed  Google Scholar 

  39. Merckelbach H, Merten T. A note on cognitive dissonance and malingering. Clin Neuropsychol. 2012;26:1217–29.

    Article  PubMed  Google Scholar 

  40. Boerjan M, Boone F, Anthierens S, et al. The impact of repeated simulation on health and healthcare perceptions of simulated patients. Patient Educ Couns. 2008;73:22–7.

    Article  PubMed  Google Scholar 

  41. Bokken L, van Dalen J, Rethans JJ. The impact of simulation on people who act as simulated patients: a focus group study. Med Educ. 2006;40:781–6.

    Article  PubMed  Google Scholar 

  42. Gerzina HA, Porfeli EJ. Mindfulness as a predictor of positive reappraisal and burnout in standardized patients. Teach Learn Med. 2012;24:309–14.

    Article  PubMed  Google Scholar 

  43. Hodges BD, McNaughton N. Who should be an OSCE examiner? Acad Psychiatry. 2009;33:282–4.

    Article  PubMed  Google Scholar 

  44. Whelan P, Church L, Kadry K. Using standardized patients’ marks in scoring postgraduate psychiatry OSCEs. Acad Psychiatry. 2009;33:319–22.

    Article  PubMed  Google Scholar 

  45. Melding P, Coverdale J, Robinson E. A ‘fair play’? Comparison of an objective structured clinical examination of final year medical students training in psychiatry and their supervisors’ appraisals. Australas Psychiatry. 2002;10:344–7.

    Article  Google Scholar 

  46. McMullen I, Checinski K, Halliwell S, et al. Peer observation in simulated CASC events and its effects on learning. Psychiatrist. 2013;37:111–5.

    Article  Google Scholar 

  47. Wallace J, Rao R, Haslam R. Simulated patients and objective structured clinical examinations: review of their use in medical education. Adv Psychiatr Treat. 2002;8:342–8.

    Article  Google Scholar 

  48. Yak A, Abdul-Hamid WK, Chad R. The objective structured clinical examination (OSCE). Psychiatrist. 2004;28:265–6.

    Google Scholar 

  49. Rudland J, Wilkinson T, Smith-Han K, et al. “You can do it late at night or in the morning. You can do it at home, I did it with my flatmate”. The educational impact of an OSCE. Med Teach. 2008;30:206–11.

    Article  PubMed  Google Scholar 

  50. Zahid MA, Al-Zayed A, Ohaeri J, et al. Introducing the objective structured clinical examination (OSCE) in the undergraduate psychiatric curriculum: evaluation after one year. Acad Psychiatry. 2011;35(6):365–9.

    Article  PubMed  Google Scholar 

  51. Brewin J, Cantwell R. Implementing the OSCE in Nottingham. Psychiatrist. 1997;21:30–2.

    Google Scholar 

Download references

Acknowledgments

The authors would like to thank colleagues at the University of Toronto who have supported, adapted and sustained the original psychiatry OSCE for 20 years, including Drs. Jodi Lofchy, Raed Hawa, and Andrea Waddell.

Author information

Authors and Affiliations

  1. Toronto General Hospital, Toronto, ON, Canada

    Brian D. Hodges, Elisa Hollenberg, Nancy McNaughton & Mark D. Hanson

  2. University of British Columbia, Vancouver, BC, Canada

    Glenn Regehr

Authors
  1. Brian D. Hodges
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elisa Hollenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nancy McNaughton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark D. Hanson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Glenn Regehr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brian D. Hodges.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hodges, B.D., Hollenberg, E., McNaughton, N. et al. The Psychiatry OSCE: A 20-Year Retrospective. Acad Psychiatry 38, 26–34 (2014). https://doi.org/10.1007/s40596-013-0012-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40596-013-0012-8

Keywords

Search

Navigation