An evaluation of the Team Objective Structured Clinical Examination (TOSCE)
Article first published online: 4 JAN 2002
Volume 33, Issue 1, pages 34–41, January 1999
How to Cite
Singleton, A., Smith, F., Harris, T., Ross-Harper, R. and Hilton, S. (1999), An evaluation of the Team Objective Structured Clinical Examination (TOSCE). Medical Education, 33: 34–41. doi: 10.1046/j.1365-2923.1999.00264.x
- Issue published online: 4 JAN 2002
- Article first published online: 4 JAN 2002
- editorial comments to authors
- Education, measurement;
- education, medical, undergraduate, methods;
- evaluation studies;
- patient simulation;
- physical examination
To evaluate the validity, reliability and feasibility of the TOSCE, a new means of formative assessment for medical students, from the perspectives of examiners, simulated patients and students.
Teams of five students rotate through five clinical stations, performing one of four tasks in turn, whilst the fifth member of the team ‘rests’.
St George's Hospital Medical School, London.
Third-year medical students, their examiners and simulated patients.
All participants felt the TOSCE session had high validity although some students were unfamiliar with some subjects. Stations were double-marked and agreement rates and Cohen's Kappa ranged from 67 to 94% and 0·04–0·88, respectively. Analysis of the causes of disagreement led to improved marking schedules and enhanced reliability.
The feasibility of the exercise as a formative assessment was demonstrated by the confidence of the staff participating both as examiners and simulated patients and from the majority of students who welcomed the learning experience.