Study On Construct Validity Of Objective Structured Clinical Examina-tion (OSCE)

Objective structured clinical examination (OSCE) has been widely used as aclinical skills assessment form in medical education area, usually consists test stationfor standardized patients, test station for clinical operation, test station for clinicaldata、test station for clinical case analysis, objective multiple-choice questions etc.,medical students pass these test stations according to a certain order; each test stationevaluation scores are weighted to form the final exam results. In the application andstudy of objective structured clinical examination, researchers have confirmed that ithas good test stability: reliability, concurrent validity and predictive validity are good,which laid the foundation of further promoting the objective structured clinicalexamination.However, for the medical test with multiple test station with situation analogy,concurrent validity and predictive validity is not enough, discuss on construct validityshould be an important process in objective structured clinical examination evaluation.At present, study on the effective of objective structured clinical examination is quiteinadequate, existing studies only concentrate on exploratory factor analysis withnon-obvious proof. Therefore, this study will target on the structure validity of theobjective structured clinical examination, evaluate its convergent validity anddiscriminate validity, clarify its structure and model oriented. At the same time, wealso try to make a breakthrough in methodology, introduce confirmatory factoranalysis（CFA）, Multitrait-multimethod approach (MTMM）, structural equationmodel (SEM) Generalizability theory (GT）etc. into the discussion of objectivestructured clinical examination’s structure validity. This study’s data sources come from clinical medical undergraduates’ scoresparticipating in objective structured clinical examination, evaluated and assed for titlequality. Expert consultation has been used to classify four groups of objectivestructured clinical examination, identified several evaluation methods (test station).Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) has beenrespectively analyses the test dimensions of clinical theory examination and clinicalthinking and clinical skills examination, clinical data test and clinical treatment abilitytest station. Multitrait-multimethod approach (MTMM) analysis has been used toevaluate the convergent validity and discriminate validity of objective structuredclinical examination, structural equation model analysis (SEM) has been used todiscuss different structure model’s fit indexes of objective structured clinicalexamination. Generalizability theory analysis (GT) has been used to quantitativeanalyses the structure validity factors of objective structured clinical examination, anddiscusses the improvement strategy.The results shows that objective structured clinical examination including severaltest stations, which classified as three test methods(test station) according to teststation’s purpose, properties, characteristics and organizational form: clinical theoryexamination, clinical thinking and operating examination, clinical data test andclinical treatment ability the exam. Exploratory factor analysis and confirmatoryfactor analysis have been used to demonstrate that, different measurement methods(test station) evaluate three clinical assessment dimensions: medical knowledge, skills,clinical thinking. Multitrait-multimethod analysis results show that objectivestructured clinical examination has high convergent validity, though discriminatevalidity is not ideal. Further SEM fitting inspection certificates that structured clinicalexamination score model presents evaluation methods (test station)situational-specific. Generalizability theory analysis result shows that: evaluationmethod (test station) number, assessment dimensions have influence on objective structured clinical examination’s structure validity and should be optimized.The results quantitative assessed the objective structured clinical examination’sstructure validity, and proves the applicability of CFA、MTMM、SEM、GT method.