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Purpose: It is uncertain whether the rater's presence during administration of the objective structured clinical examination (OSCE) has any impact on examinee performance. To clarify this issue, the effects of a rater's presence during testing on OSCE score and examinee responses were analyzed. Methods: The OSCE comprised 24 stations of 12 duplicated cases. Twenty-eight of 83 fourth-year medical students were placed in four rater-absent stations (pediatrics, 2 stations; internal medicine, 2 stations). The scores of the rater-absent group were assessed after review of recorded videotapes. We obtained student responses on the rater's presence by means of a questionnaire. Statistical analysis (t-test) was performed using SPSS 14.0. Results: The scores of the rater-absent group compared with the rater-present group were 78.57±16.27 vs. 70.55±19.57 (p=0.066) for pediatrics, 66.07±14.74 vs. 64.36±14.88 (p=0.621) for internal medicine, and 67.75±5.43 vs. 69.13±4.85 (p=0.099) for total score, respectively. Subjects in the rater-absent group felt that they were in a real-life clinical situation (p=0.013) and concentrated better (p=0.006), and more students requested to take the OSCE without a rater in the station (p=0.000) than those in rater-present group. Conclusion: Although there was no significant difference in OSCE scores between the rater-absent and rater-present examinee groups, subjects at rater-absent stations felt more of a real clinical situation and could concentrate more effectively than those at rater-present stations. To this end, videotaped OSCE assessments should be considered to increase the validity of the examination.

Effects of Rater's Presence in OSCE Station on Examinee's Scores