Assessors agree on students' clinical skills more than their bedside manner.

Medical exams can shape a doctor's entire career, so tests must be graded fairly. In France, medical students take practical exams called OSCEs, where they act out medical scenarios. Researchers wanted to know if two different examiners watching the same student would give the same score. They studied a pediatric training program where two separate examiners graded each student at each test station using yes-or-no checklists. The checklists covered medical tasks, called clinical skills, as well as behavior and communication, called general skills. The researchers found that the two examiners agreed well on clinical skills. However, they agreed only moderately on general skills. Agreement between the examiners also changed depending on the medical case and was lower for students who earned lower overall scores. More complex illnesses, like pediatric tuberculosis and hemolytic uremic syndrome, showed greater scoring differences between examiners than a common lung infection called bronchiolitis.

Why it matters

For French medical students, OSCE scores determine their rank and specialty placement. If two assessors give different scores for bedside manner, a student's future could depend on which rater they get. This study shows that checks should be tightened for subjective skills and rare clinical cases.

Questions answered