For decades in undergraduate medical, dental and health science curricula, clinical competence and Multiple Mini Interviews have been assessed using Objective Structured Clinical Examinations (OSCEs) (Harden, 1988; Harden & Gleeson, 1979). Although OSCEs and MMI’s are known to be robust and useful assessments, the paper trail is laborious and expensive (Cusimano et al., 1994; Frye, Richards, Philp, & Philp, 1989). An OSCE or MMI contains various stations designed to assess students’ skills with judgement made by examiners and, sometimes simulated patients. Cost-effectiveness is an increasingly important consideration in medical education, although rarely reported in the literature (Ratanawongsa et al., 2008; Walshe & Smith, 2006).
Estimations of the development and administration of, a six-station OSCE report 327.5 hours of staff and faculty time for each rotation of students. That equates to 8.2 hours of staff involvement per student (Cusimano et al., 1994). The implementation required 110 hours of staff and faculty time (2.75 hours per student). According to Cussimano, direct expenses for the OSCE amounted to US$ 6.90, equivalent to €4.70 per student per station (Cusimano et al., 1994).
Our medical school administers on average eleven, 7-12 station OSCEs for a cohort of 670 students, produces 9380 assessment forms over the curriculum. To produce final OSCE results, the administrative cost of this procedure is €29,500, which is €2.80 per paper form. Attempts have been made to streamline OSCE administrative processes.
Although widely used to store and analyse OSCE data, Optical Mark Readers (OMR) have several problems (Lindemann, Rock, Locke, & Johnson, 1991). These are associated with inflexible assessment forms, error messages while scanning the forms, additional printing costs and limited descriptive statistics of the analysis. Adaptation of OMR software solutions to customise an institution wide variability of OSCE stations forms can be expensive. The advent of dynamic Web 2.0 technology is an exciting alternative to OMR.
Currently, quite a few prestigious Universities and Professional Bodies are using our system Qpercom Observe for retrieval, storage and analysis of OSCE and MMIs stations. On average the cost per electronic transition is 70% cheaper and much faster than the traditional paper trail.