Assessing confidence and competence of senior medical students in an obstetrics and gynaecology clerkship using an OSCE

Context: Assessment of clinical confidence and competence of senior medical students during an obstetrics and gynaecology clerkship using an objective structured clinical examination (OSCE). Method: A questionnaire was distributed to senior medical students (n=47) to assess pre- and post-OSCE self-perceived confidence and competence in five clinical skills: history taking, performing pelvic examination, interacting and communicating with patients, clinical reasoning and dealing with difficult patient situations. Pre- and post-performance confidence levels were compared and correlated with OSCE scores. Results: The five clinical skills were significantly interrelated (p=0.001). There was no significant difference in OSCE performances between male (n=16) and female (n=31) students. Pre- and post-OSCE confidence in performing pelvic examination was significantly higher in female than male students (p=0.01). Post-OSCE confidence in clinical reasoning and dealing with difficult patient situations only were significantly increased in both groups (p=0.01 and p=0.02, respectively). Pre- and post-performance confidence levels were not significantly correlated to OSCE scores. Conclusion: Of five clinical skills rated, self-confidence in clinical reasoning skills and dealing with challenging or complex patient problems only were significantly increased after an OSCE assessing competence. The content of some of our OSCE stations thus enhance confidence in these skills but psychometric and other characteristics of the OSCE such as duration and performance feedback mechanisms need further investigation.