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J Educ Eval Health Prof > Epub ahead of print
J Educ Eval Health Prof. 2018; 15: 17.
Published online July 18, 2018.
[Epub ahead of print]
Examiner seniority and experience are associated with bias when scoring communication but not examination skills in Objective Structured Clinical Examinations (OSCEs) in Australia
Lauren Chong1  , Silas Taylor2  , Matthew Haywood2  , Barbara-Ann Adelstein3  , Boaz Shulruf4 
1Clinical Skills Teaching Unit, Prince of Wales Hospital, Sydney, Australia
2University of New South Wales, Sydney, Australia
3Prince of Wales Clinical School, University of New South Wales, Sydney Australia
4Office of Medical Education, University of New South Wales, Sydney, Australia; Centre for Medical and Health Sciences Education, University of Auckland, Auckland
Correspondence  Boaz Shulruf ,Email:
Editor:  Sun Huh, Hallym University, Korea
Submitted: February 20, 2018  Accepted after revision: July 18, 2018
There is good understanding of biases which may influence OSCE examiners’ scoring, with recent research attempting to establish the magnitude of their impact. However, the influence of examiner experience, clinical seniority and occupation on communication and physical examination scores in OSCEs has not yet been clearly established.
We compared the mean scores awarded for generic and clinical communication and physical examination skills in relation to examiner characteristics (gender, examining experience, occupation, seniority and speciality) across two undergraduate Medicine OSCEs. The statistical significance of differences were calculated using two-tailed independent t-test and ANOVA.
Five hundred and seventeen students were examined by 237 examiners at UNSW in 2014 and 2016. Examiner gender, occupation (academic, clinician or clinical tutor) and job type (specialist or generalist) did not significantly impact on scores. Junior doctors scored consistently higher than senior doctors in all domains; this difference was statistically significant for generic and clinical communication scores. Examiner experience was significantly inversely correlated with generic communication scores.
We suggest assessment of examination skills is less susceptible to bias because this process is fairly prescriptive, affording greater scoring objectivity. We recommend training that defines the marking criteria, teaching curriculum and expected level of performance in communication skills to reduce bias in OSCE assessment.
Keywords: Examiner, bias, communication, examination, OSCE, Australia
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