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Background <p>The Objective Structured Clinical Examination (OSCE) is a standard tool for assessing clinical competence in standardized residency training. However, detailed multi‑station performance analyses focusing on critical care residents are limited. This multicenter retrospective cohort study evaluated OSCE scores across training bases in Zhejiang Province to identify educational gaps and inform training optimization.</p> Methods <p>We retrospectively collected clinical competency assessment scores of 175 residents from seven standardized residency training bases (2023–2025), including all eligible residents during the study period (total population sampling; no formal sample size calculation was required). Data were collected using standardized OSCE scoring sheets. The OSCE included seven stations: History Taking (HT), Physical Examination (PE), Initial Medical Progress Note (IMPN), Comprehensive Medical Record (CMR), Clinical Reasoning and Decision‑making (CRDM), Basic Clinical Skills (BCS), and Specialty‑specific Clinical Skills (SCS). Kruskal–Wallis, Mann–Whitney U tests, and Spearman’s correlation with Bonferroni correction were used for analysis.</p> Results <p>The overall pass rate was 97.71% (171/175). Significant inter‑base differences were found only for IMPN (<i>P</i> = 0.004) and CMR (<i>P</i> &lt; 0.001). No significant differences were observed across trainee types or genders. CRDM had the lowest median score (85.0 pts) and widest distribution. Only HT and PE showed a moderate positive correlation (ρ = 0.60, <i>P</i> &lt; 0.001 after correction). Annual trends revealed progressive improvement in HT and PE (2025 vs. 2023, both <i>P</i> ≤ 0.004), while IMPN and SCS peaked in 2024 then declined (both <i>P</i> &lt; 0.001).These results directly address the study aim of comparing performance across bases, trainee types, genders, and years.</p> Conclusions <p>Critical care residents performed well in procedural skills, but clinical reasoning remains a notable weakness, and documentation quality varies across bases. These findings support the need for systematic clinical reasoning training, cross-institutional standardization of medical writing, and continuous quality monitoring to improve competency-based education in critical care medicine.</p>

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Analysis of OSCE-based clinical competency assessment among critical care medicine residents in Zhejiang Province, China: a multicenter retrospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年5月25日

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  • Changqin Chen,
  • Wenchao Mao,
  • Kailun Cai,
  • Caibao Hu,
  • Changyun Zhao

摘要

Background

The Objective Structured Clinical Examination (OSCE) is a standard tool for assessing clinical competence in standardized residency training. However, detailed multi‑station performance analyses focusing on critical care residents are limited. This multicenter retrospective cohort study evaluated OSCE scores across training bases in Zhejiang Province to identify educational gaps and inform training optimization.

Methods

We retrospectively collected clinical competency assessment scores of 175 residents from seven standardized residency training bases (2023–2025), including all eligible residents during the study period (total population sampling; no formal sample size calculation was required). Data were collected using standardized OSCE scoring sheets. The OSCE included seven stations: History Taking (HT), Physical Examination (PE), Initial Medical Progress Note (IMPN), Comprehensive Medical Record (CMR), Clinical Reasoning and Decision‑making (CRDM), Basic Clinical Skills (BCS), and Specialty‑specific Clinical Skills (SCS). Kruskal–Wallis, Mann–Whitney U tests, and Spearman’s correlation with Bonferroni correction were used for analysis.

Results

The overall pass rate was 97.71% (171/175). Significant inter‑base differences were found only for IMPN (P = 0.004) and CMR (P < 0.001). No significant differences were observed across trainee types or genders. CRDM had the lowest median score (85.0 pts) and widest distribution. Only HT and PE showed a moderate positive correlation (ρ = 0.60, P < 0.001 after correction). Annual trends revealed progressive improvement in HT and PE (2025 vs. 2023, both P ≤ 0.004), while IMPN and SCS peaked in 2024 then declined (both P < 0.001).These results directly address the study aim of comparing performance across bases, trainee types, genders, and years.

Conclusions

Critical care residents performed well in procedural skills, but clinical reasoning remains a notable weakness, and documentation quality varies across bases. These findings support the need for systematic clinical reasoning training, cross-institutional standardization of medical writing, and continuous quality monitoring to improve competency-based education in critical care medicine.