Critical Synthesis Package: Cultural Competence OSCE (ccOSCE)

Publication ID Published Volume
9428 June 6, 2013 9

Abstract

This Critical Synthesis Package contains (1) a Critical Analysis of the psychometric properties and application to health sciences education for the Cultural Competence OSCE (ccOSCE); and (2) a copy of the ccOSCE instrument and checklist developed by Alexander Green, MD.

The ccOSCE is a one-station, performance-based assessment of medical students’ ability to elicit and comprehend the sociocultural causes of health outcomes. It features a middle-aged ethnic minority woman for whom a combination of sociocultural factors, including an inaccurate understanding of hypertension, have led to medication non-adherence and complaints of inability to control her blood pressure. Within a 15-minute time limit, examinees must take a patient history, present the patient’s case orally to an examiner, and answer a short-answer question about the case. Performance is rated using multiple, conceptually founded checklists. The ccOSCE may augment an OSCE that does not assess cultural competence, but its fit to other OSCE stations will require negotiation of implementation procedures and assessment criteria as well as quantitative evaluation to ensure the reliability of the full exam. Scoring guidance is not provided, and initial validation has been conducted qualitatively. Adoption of the ccOSCE may raise awareness of how to assess cultural competence via modifications to extant OSCE stations.

  • The ccOSCE presents one patient case that requires the ability to elicit and comprehend the sociocultural factors that affect health outcomes. Multiple cases are necessary to create a reliable stand-alone assessment of these constructs. The ccOSCE’s conceptual foundation facilitates the development of a reliable multi-station assessment.
  • The ccOSCE may augment an OSCE that does not assess cultural competence, however its fit to the other OSCE stations will require negotiation of implementation procedures and assessment criteria as well as quantitative evaluation. Adoption of the ccOSCE may raise awareness of how to assess cultural competence via modifications to extant OSCE stations.
  • The ccOSCE does not contain instructions for how to score each checklist or how checklist scores should be aggregated to produce a summary score. Such guidance is necessary to evaluate the psychometric properties of the measure (e.g., difficulty, score distributions, part-whole correlation with OSCE total score, inter-rater reliability, etc.) as well as other validity evidence (e.g., fairness of scoring procedures, relation to other measures of cultural competence and communication skills, sensitivity to instruction in these areas, etc.).


Citation

Cianciolo A. Critical synthesis package: cultural competence OSCE (CCOSCE). MedEdPORTAL Publications. 2013;9:9428. http://doi.org/10.15766/mep_2374-8265.9428

Educational Objectives

  1. To describe the purpose and basic properties of the ccOSCE, including number of items and scales, and psychometric properties.
  2. To describe the application of the ccOSCE to the field of health sciences education.
  3. To evaluate the relative strengths and weaknesses of the ccOSCE.
  4. To provide the ccOSCE and checklist to aid in its administration.

Keywords

  • Cultural Competence, OSCE, Critical Analysis, Cultural Competency, DREAM, Directory and Repository of Educational Assessment Measures, Health Equity Research

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