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J Educ Eval Health Prof > Epub ahead of print
J Educ Eval Health Prof. 2017; 14: 34.
Published online December 27, 2017.
[Epub ahead of print]
The sights and insights of examiners in objective structured clinical examinations
Lauren Chong1  , Silas Taylor2  , Matthew Haywood3  , Barbara-Ann Adelstein4  , Boaz Shulruf5 
1Medical student, Clinical Skills Teaching Unit, Prince of Wales Hospital, Sydney, Australia
2Clinical Skills Convenor, University of New South Wales, Sydney, Australia
3Learning and Teaching fellow, University of New South Wales, Sydney, Australia
4Senior Lecturer, Prince of Wales Clinical School, University of New South Wales, Sydney Australia
5Associate Professor, Office of Medical Education University of New South Wales, Sydney, Australia; Honorary Associate Professor, Centre for Medical and Health Sciences Education, University of Auckland, Auckland
Correspondence  Boaz Shulruf ,Email:
Editor:  Sun Huh, Hallym University, Korea
Submitted: December 18, 2017  Accepted after revision: December 27, 2017
The objective structured clinical exam (OSCE) is considered one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners’ assessment scores are influenced by several factors which may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners’ assessments.
We performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area.
OSCE examiners’ assessment scores are influenced in four different domains: examination context, examinee characteristics, examinee-examiner interactions and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects, examiner gender and ethnicity, training, lifetime experience in assessing, leadership and familiarity with students, station type and site effect.
There are several factors that may influence the presumed objectivity of examiners’ assessments and which need to be addressed to ensure objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.
Keywords: Assessment, Australia, checklist, judgment

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