OSCE Standard Setting by Borderline Regression Method in Taylor’s Clinical School

Abstract

Objective structured clinical examination (OSCE) is the main assessment tool for the end of semester (EOS) summative continuous assessment for the clinical training (Phase 2) at the Taylor’s Clinical School. OSCE is a clinical competency assessment, whereby a candidate who passes the OSCE is deemed as clinically competent. The traditional way of deciding the pass score as 50 % in any examination is arbitrary; this may lead to problem in OSCE where the score of 50 % (pass score) may not represent the actual competency required. In recent years, standard setting methods have been applied in OSCE by many medical schools so that a defensible, fair and absolute pass score is determined. The aim of this study is to describe the OSCE cut-off score by the borderline regression method (BRM) in Taylor’s Clinical School (TCS) compared to the conventional arbitrary pass mark of 50 %. This study focused on the following two research questions: (1) What is the difference in cut-off (pass mark) of OSCE if BRM standard setting is applied? (2) What is the difference in OSCE pass rate if BRM is applied? The results of EOS 5 and EOS 7 were tabulated, and the BRM standard setting was applied to these two OSCEs. The results showed that the mean score of both EOS OSCEs was significantly lower after BRM standard setting (P = 0.001). With BRM standard setting, it was able to identify more poor performers in OSCE who may have passed if the conventional arbitrary pass mark of 50 % was applied. We concluded that BRM standard setting is feasible and is a reasonable as well as defensible method of standard setting for OSCE. We recommend BRM for all OSCEs in Taylor’s Clinical School.