Structured Assessments of Clinical Competence
Abstract
With the development of work-based learning methods to assess clinical performance in a more authentic and naturalistic way, there is the potential for confusion over terminology. This chapter considers assessments of clinical competence to be measures of what doctors can do in controlled representations of professional practice, i.e. under examination conditions. A variety of formats for assessing clinical competence have been developed over the years. The chapter reviews the more 'classical' long case and short case formats, and also describes newer formats such as the OSCE and Objective Structured Long Case Examination Record (OSLER). The OSCE is an assessment format in which the candidates rotate sequentially around a series of structured cases located in 'stations', at each of which specific tasks have to be performed. OSCEs are more reliable than unstructured observations in four main ways: more consistent scoring, overall competence, increase in reliability, and multiple independent observations are collated.
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Clear rubrics improve students' understanding of assessment criteria and enhance their performance.
“Research demonstrates that clear rubrics not only improve students' understanding of assessment criteria but also enhance their performance.”
From Formative assessment and feedback in medical education: A practical guide: AMEE Guide No. 189 (2026) · cites this paper as [56]
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- Authors
- Boursicot, K. A. M., Roberts, T. E., & Burdick, W. P.
- Affiliations
- University of Leeds (GB)
- Foundation for Advancement of International Medical Education and Research (US)
- Venue
- Understanding Medical Education
- Publisher
- Wiley
- Published
- 2018-10-05
- Pages
- 335-345
- OpenAlex
- W4249012212
- Cited by
- 6
- References
- 50
- Citations by year
- 2025: 2 · 2022: 2 · 2020: 2
- Type
- other
- Language
- en
- Open access
- closed
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical Education and Admissions
- Keywords
- clinical competence assessment, OSCE, long case examination, Osler, assessment reliability, medical education, work-based learning
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