Association between end-of-third-year objective structured clinical examinations and accreditation council for graduate medical education milestones during intern year

The Objective Structured Clinical Examinations (OSCEs) administered in medical schools have increased in importance with the elimination of United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS). The purpose of this study was to understand the association between student performance on an end-of-third-year OSCE and performance in residency. This study explored the correlations between OSCE performance and relevant Accreditation Council for Graduate Medical Education (ACGME) milestone 1.0 performance. This study included students’ scores from 139 Sidney Kimmel Medical College (SKMC) students who completed an end-of-third-year OSCE during 2015 and 2016 and completed an intern year in Internal Medicine (IM). Main outcomes were the relevant IM sub-competencies: Patient Care (PC1-information gathering and PC2-management plan) and Interpersonal and Communication Skills (ICS1-patient communication and ICS2-team communication). The correlations between the OSCE Integrated clinical encounter (ICE) scores and PC1, PC2, and ICS1 were statistically significant; the correlation with ICS2 did not reach significance. The strongest correlation was between the OSCE ICE score and PC1 (r = 0.28 with 95% confidence interval of [0.12, 0.43]). There was not a statistically significant relationship between the OSCE Communication Skills scores and any of the Milestone 1.0 ratings - PC1, PC2, ICS1 or ICS2, though all correlations were positive. The magnitude of the correlations and 95% confidence intervals suggest the significant effects were small. This study found a correlation between student OSCE performance and ACGME milestone 1.0 patient care and interpersonal and communication skills sub-competencies. OSCE scores could contribute additional information to the data currently used as an educational handoff in students’ transition to residency.