Implementing the objective structured clinical examination in a traditional medical school

Since 1985 at the University of North Carolina at Chapel Hill School of Medicine, an objective structured clinical examination (OSCE) has been implemented at the completion of the second year as the final examination in physical diagnosis. This paper describes the format of the examination and the results of surveys of students and evaluators made in 1987, 1988, and 1989. Both the students and the evaluators (who were faculty, residents, and fellows) showed overwhelming acceptance and support of the OSCE. The data indicate that this reaction is partially because the examination is structured as a mechanism for teaching as well as for evaluation.