Relationships between students' clinical experiences in introductory clinical courses and their performances on an objective structured clinical examination (OSCE)

Purpose. To elucidate the link between the quantity and quality of clinical exposure gained by first-year clinical students in hospital settings and their performance on a subsequent comprehensive assessment of clinical skills (the objective structured clinical examination, or OSCE). Method. Data relating to educational activities and workload were collected for the second introductory clinical attachment undertaken by 152 (of 246) students in two British medical colleges prior to a joint comprehensive 22-station OSCE administered in May 1994. Pearson correlation coefficients were used as the main analytical tool to study the relationships between measures of clinical activity and total OSCE scores. Results. In general, of 43 indices of the amount, nature, and quality of bedside, ward-based, or outpatient experience, only six correlated with OSCE scores. The strongest links were for whether students examined outpatients on their own (r = .2), whether the objectives had been made clear (r = .19), and the number of clinics attended (r = .18). Variables meeting the criteria were entered into a backwards stepwise regression analysis to predict total OSCE scores, but they explained only 23% of the variance. Conclusion. The association between clinical experience and educational outcomes remains poorly understood.