A pilot study of marking accuracy and mental workload as measures of OSCE examiner performance.

BACKGROUND: The Objective Structured Clinical Examination (OSCE) is now a standard assessment format and while examiner training is seen as essential to assure quality, there appear to be no widely accepted measures of examiner performance. METHODS: The objective of this study was to determine whether the routine training provided to examiners improved their accuracy and reduced their mental workload. Accuracy was defined as the difference between the rating of each examiner and that of an expert group expressed as the mean error per item. At the same time the mental workload of each examiner was measured using a previously validated secondary task methodology. RESULTS: Training was not associated with an improvement in accuracy (p = 0.547) and that there was no detectable effect on mental workload. However, accuracy was improved after exposure to the same scenario (p < 0.001) and accuracy was greater when marking an excellent compared to a borderline performance. CONCLUSIONS: This study suggests that the method of training OSCE examiners studied is not effective in improving their performance, but that average item accuracy and mental workload appear to be valid methods of assessing examiner performance.

The role of anxiety sensitivity in symptom perception after minor head injury: an exploratory study.

PRIMARY OBJECTIVE: This exploratory study examined the role of anxiety sensitivity (AS) as a factor contributing to outcome following minor head injury (MHI). Recent research has implicated AS in perception of pain intensity after orthopaedic trauma. AS, therefore, has the potential to mediate perception of and reaction to post-concussion symptoms at an early stage of recovery, increasing the risk of a protracted and incomplete recovery. RESEARCH DESIGN: A case series analysis. METHODS AND PROCEDURES: Sixty-three head trauma patients referred from an accident and emergency unit to an acute minor head injury service were compared to 58 patients who had suffered recent orthopaedic injury. Participants completed the Rivermead Post-Concussion Questionnaire (RPQ), to determine the number and severity of head injury-related symptoms, and the Anxiety Sensitivity Index (ASI), to measure their emotional reaction to symptoms. MAIN OUTCOMES AND RESULTS: Significant between-group differences were found for both RPQ and ASI measures. The MHI group reported more serious symptoms. Both groups also recorded significant positive correlations between the RPQ and ASI measures, with a stronger relationship recorded for the MHI group. CONCLUSIONS: The results support the impression that anxiety sensitivity may be an important factor mediating perception of symptoms after injury, potentially influencing speed and quality of recovery.