Skip to content. Skip to navigation

Faculty Development

You are here: Home / Structured Assessments of Clinical Competence
Structured Assessments of Clinical Competence

Structured Assessments of Clinical Competence

PLEASE NOTE: These modules have now been transferred to the HEE e-Learning for Health platform and should be accessed via

No new accounts should now be created. Please follow the above link to access the modules.

This suite of modules will be completely decommissioned in September 2017, from which point it will no longer be accessible.

Clinical teachers are often involved in assessments of clinical competence in the workplace, in universities and Colleges. Assessments commonly used to formally assess clinical competence include long and short cases and the objective structured clinical examination which, if well designed, is a fair and reliable method of assessing clinical competence.

This module outlines the theoretical principles underlying the development of modern structured assessments of clinical competence and describes some practical aspects of designing and implementing objective structured clinical examinations (OSCEs).

The reliable and valid assessment of clinical competence has become an increasingly important area of concern in medical education as the psychometric properties of different assessment tools have been researched and better understood.

While Miller’s model of professional competence (Miller, 1990) illustrates that competence is underpinned by a thorough base of specialist medical knowledge, the term clinical competence encompasses other professional practice elements such as history taking and clinical examination skills, skills in practical procedures, doctor-patient communication, problem solving ability and management skills, relationships with colleagues and ethical behaviour.

As written tests do not assess clinical skills, the assessment of clinical competence has historically involved the direct observation of candidates by professional colleagues. A variety of formats for assessing clinical competence has developed over the years including the ‘classic’ long and short case formats and newer methods such as the OSCE.

Before you start

Before you start the module, we recommend that you spend a few minutes thinking about the following points and noting down some of your thoughts. If you are registered on the site, you can do this in the ‘reflections area’. Click on the ‘my area’ link at the top of the page to access your personal pages. Please note that you must be logged in to do this. Please also note that you will need to contribute to the ‘reflections area’ during the course of the module in order to complete and print out your certificate.

Thinking points:

How would you describe your own experience of clinical assessment:
(a) As a learner?
(b) As a teacher?

What formal structures were/are used in these assessments?

How do you think these types of assessments work in assessing clinical competence and performance?

Creative Commons Licence
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 2.0 UK: England & Wales License.

Print module to PDF

Save a PDF of this module, so you can print it and read it in your own time.

Email your comments

Let us know what you think about this module or give us your feedback.

Further information

More information about this module, further reading and a complete list of glossary terms.

Learning activities

Read about the recommended learning activities for this module.