A collaborative comparison of Objective Structured Clinical Examination (OSCE) standard setting methods at Australian medical schools

Malau-Aduli, Bunmi Sherifat, Teague, Peta-Ann, D'Souza, Karen, Heal, Clare, Turner, Richard, Garne, David L., and van der Vleuten, Cees (2017) A collaborative comparison of Objective Structured Clinical Examination (OSCE) standard setting methods at Australian medical schools. Medical Teacher, 39 (12). 7. pp. 1261-1267.

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Abstract

Background: A key issue underpinning the usefulness of the OSCE assessment to medical education is standard-setting, but the majority of standard-setting methods remain challenging for performance assessment because they produce varying passing marks. Several studies have compared standard setting methods; however, most of these studies are limited by their experimental scope, or use data on examinee performance at a single OSCE station or from a single medical school. This collaborative study between ten Australian medical schools investigated the effect of standard-setting methods on OSCE cut scores and failure rates.

Methods: This research used 5,256 examinee scores from seven shared OSCE stations to calculate cut scores and failure rates using two different compromise standard-setting methods, namely the Borderline Regression and Cohen's methods.

Results: The results of this study indicate that Cohen's method yields similar outcomes to the Borderline Regression method, particularly for large examinee cohort sizes. However, with lower examinee numbers on a station, the Borderline Regression method resulted in higher cut scores and larger difference margins in the failure rates.

Conclusion: Cohen's method yields similar outcomes as the Borderline Regression method and its application for benchmarking purposes and in resource-limited settings is justifiable, particularly with large examinee numbers.

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