TY - JOUR T1 - Validation of a large-scale clinical examination for international medical graduates JF - Canadian Family Physician JO - Can Fam Physician SP - e408 LP - e417 VL - 58 IS - 7 AU - Susan Glover Takahashi AU - Arthur Rothman AU - Marla Nayer AU - Murray B. Urowitz AU - Anne Marie Crescenzi Y1 - 2012/07/01 UR - http://www.cfp.ca/content/58/7/e408.abstract N2 - Objective To evaluate a new examination process for international medical graduates (IMGs) to ensure that it is able to reliably assign candidates to 1 of 4 competency levels, and to determine if a global rating scale can accurately stratify examinees into 4 levels of learners: clerks, first-year residents, second-year residents, or practice ready. Design Validation study evaluating a 12-station objective structured clinical examination. Setting Ontario. Participants A total of 846 IMGs, and an additional 63 randomly selected volunteers from 2 groups: third-year clinical clerks (n = 42) and first-year family medicine residents (n = 21). Main outcome measures The accuracy of the stratification of the examinees into learner levels, the impact of the patient-encounter ratings and postencounter oral questions, and between-group differences in total score. Results Reliability of the patient-encounter scores, postencounter oral question scores, and the total between-group difference scores was 0.93, 0.88, and 0.76, respectively. Third-year clerks scored the lowest, followed by the IMGs. First-year residents scored highest for all 3 scores. Analysis of variance demonstrated significant between-group differences for all 3 scores (P < .05). Postencounter oral question scores differentiated among all 3 groups. Conclusion Clinical examination scores were capable of differentiating among the 3 groups. As a group, the IMGs seemed to be less competent than the first-year family medicine residents and more competent than the third-year clerks. The scores generated by the postencounter oral questions were the most effective in differentiating between the 2 training levels and among the 3 groups of test takers. ER -