Publications
Feasibility and utility of objective structured clinical examination (OSCE) as an end-of internship assessment of MBBS training in a medical college in Southern India
Jananee Muralidharan, Sanjiv Lewin Suneetha Nithyanandam, John Stephen Mary Joseph Lakshmi TA Pretesh Rohan Kiran Nachiket Shankar Sumithra Selvam and Prem Mony Abstract
Background and aims The undergraduate MBBS course (Bachelor of Medicine, Bachelor of Surgery) in India is
designed to produce competent Indian Medical Graduates (IMGs) capable of addressing community health needs.
The preparedness of these graduates for clinical practice remains a crucial area of investigation. Objective Structured
Clinical Examinations (OSCEs) have emerged as a robust assessment tool for evaluating clinical competencies. This
study aims to assess the feasibility and utility of the OSCE when used as an end-of-internship evaluation, describe
temporal trends in OSCE performance, and analyze the correlation between OSCE scores and final-year MBBS
examination results over a six-year period at a center in South India.
Methods A descriptive study was conducted at a medical college in South India, involving six batches of students
(2017–2023; n = 469). OSCE stations were designed to assess cognitive, psychomotor, and affective domains. The
feasibility and utility of this exercise was assessed. OSCE scores were analyzed across domains and subdomains, and
correlations with final-year MBBS examination scores were explored using Pearson’s correlation coefficient. Statistical
significance was set at p < 0.05.
Results The OSCE was found to be a resource-intensive evaluation, requiring 528 faculty-hours for a batch of
60 students and 843 faculty-hours for a batch of 150. The mean OSCE score was 61.3 ± 8.0%, with the highest
performance in the affective domain (72.1 ± 14.2%) and the lowest in the cognitive domain (50.0 ± 15.4%). Notably,
psychomotor skills were inversely correlated with cognitive skills (-0.41, p < 0.001). OSCE scores were weakly correlated
with final-year MBBS examination marks (r = 0.44, p < 0.001), with stronger correlations in smaller batches (r = 0.57,
p < 0.001) than larger ones (r = 0.44, p < 0.001). The COVID-19 pandemic and increased batch sizes negatively impacted
clinical and technical skill performance.
Conclusion It is feasible to conduct OSCEs as an end of internship assessment in a medical college. OSCEs serve as
a comprehensive assessment tool, underscoring the importance of multi-modal evaluation strategies. Conducting
