SP’s role-portrayal in Swiss high-stakes clinical exams is of high quality and improves over time as measured with the FAIR-OSCE

Abstract

Introduction/Overview/Purpose In high-stakes clinical exams, the quality of SPs' role-portrayal is of utmost importance for exam fairness and validity. The role of SP trainers is vital in ensuring the authenticity and standardization of SP role-portrayal. This study focuses on the clinical skills part of the Swiss federal licensing exam (CS-FLE) and aims to assess the quality of SP role-portrayal over time.

Methodology & Methods A cohort study was conducted, involving five Swiss SP programs responsible for delivering the CS-FLE. Data on SP role-portrayal were collected from 2016 to 2021 by different local and one central SP trainers as observers using the FAIR-OSCE instrument developed in a literature-based consensus building process together with an interfaculty board of SP trainers in Switzerland. It assesses 4 dimensions of SP role-portrayal: introduction (3 items), delivery of information (7 items), portrayal (7 items), and others (3 items). Scores were defined as follows: Quality criterium fulfilled “completely agree = 2”, "agree = 1", "do not agree = -1". Items rated as not applicable were not included into the calculation. An ANOVA was calculated over the 5 exams.

Results/Outcome/Discussion Results: The analysis of the altogether 1804 FAIR-OSCE ratings revealed a high general quality of SP role-portrayal and a statistically significant (2016-2021 p= < 0.001) continuous improvement in role-portrayal quality over the study period. Specifically, the results indicated that the overall mean scores representing the quality of role-portrayal increased continuously, from 1.75 in 2016 to 1.84 in 2021. None of the items received "do not agree" ratings exceeding 5%. Discussion: This study demonstrates that SP role-portrayal in Swiss high-stakes clinical exams is consistently of high quality and meaningfully improves over time. The findings suggest that the FAIR-OSCE instrument effectively provides an efficient means to monitor and evaluate the quality of SP role-portrayal in high-stakes clinical exams.

Conclusion SPs' role-portrayal in Swiss high-stakes exams is consistently of high quality and demonstrates continuous improvement over time. The FAIR-OSCE instrument has proven effective and valid in monitoring and enhancing SP role-portrayal quality.