An experimental study looking at whether the medical student’s non-native English accent affects the examiner’s scoring during an objective structured clinical examination (OSCE)
| ISRCTN | ISRCTN17360102 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN17360102 |
| ClinicalTrials.gov (NCT) | Nil known |
| Clinical Trials Information System (CTIS) | Nil known |
| Protocol serial number | Nil known |
| Sponsor | Queen Mary University of London |
| Funder | Queen Mary University of London, Centre for Medical Education, Insititute of Health Sciences Education |
- Submission date
- 14/04/2020
- Registration date
- 15/04/2020
- Last edited
- 06/10/2020
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Assessment of clinical competence is an important aspect of the assessment in medical education. Objective Structured Clinical Examination (OSCE) is an assessment tool commonly used for such purpose. In an OSCE, medical students rotate through a set number of stations. In one station, there is typically one examiner who observes the student. There may be a simulated/real patient, a manikin, relevant equipment or clinical information. Each time a student enters a station, he/she is given a scenario with a task to complete, including practical procedures or patient managements. Students’ performance is marked by the examiner using a checklist or rating scale. It is stated OSCEs are superior to other assessment methods such as written examination or long cases due to the high construct validity, the standardised cases and marking schemes.
OSCEs need to produce reliable measurements of the students’ competence. It is imperative to monitor the standard and quality of the OSCE examiners. Minimising the examiner bias ensures that the difference in the scores is due to the students’ performance. Despite the implementation of the examiner training, a systematic review has described that OSCEs were highly variable in their reliability. There have been anecdotes that students with non-native English accents (NNEAs) were marked lower than those with native English accents (NEAs). No medical education research has investigated the effect of accents in an OSCE. Therefore, it is important to establish whether such bias exists.
Thus, the primary objective of this study was to test a hypothesis that OSCE examiners scored students with NNEAs lower compared to students with NEAs when the performance is constant.
Who can participate?
OSCE examiners in the UK who have had formal OSCE examiner training.
What does the study involve?
A professional actor will play a medical student. Two near identical scripts will be prepared. Two videos are made showing the actor speaking with an Indian accent and two videos are made showing the actor speaking without the accent in either script. UK OSCE examiners will be recruited online and randomly assigned to two groups. They will watch two videos online, each with either script, with and without the Non-Native English Accent. For each video performance, examiners will be asked to give an individual score to each checklist item and a global score.
What are the possible benefits and risks of participating?
None
Where is the study run from?
Queen Mary University of London, Centre for Medical Education, Institute of Health Sciences Education (UK)
When is the study starting and how long is it expected to run for?
March 2019 to April 2019
Who is funding the study?
Queen Mary University of London, Centre for Medical Education, Institute of Health Sciences Education (UK)
Who is the main contact?
An Kozato, a.kozato@smd15.qmul.ac.uk
Contact information
Public
Barts and The London School of Medicine and Dentistry
Garrod Building
Turner Street
Whitechapel
London
E1 2AD
United Kingdom
 ORCID ID |
0000-0002-6955-3653 |
|---|---|
| Phone | +44 (0)20 7882 2239 |
| a.kozato@smd15.qmul.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Interventional randomized single-blinded controlled trial |
| Secondary study design | Randomised controlled trial |
| Study type | Participant information sheet |
| Scientific title | A randomised controlled trial of the influence of non-native English accents on examiners’ scores in OSCEs |
| Study objectives | OSCE examiners score students with non-native English accents lower compared to students with native English accents when the performance is constant. |
| Ethics approval(s) | Approved 19/02/2019, Queen Mary Ethics of Research Committee (Room W104, Queen’s Building, Queen Mary University of London, Mile End Road, London, E1 4NS, UK; +44(0)20 7882 7915; h.covill@qmul.ac.uk), ref: QMERC2018/95 |
| Health condition(s) or problem(s) studied | Undergraduate medical education and clinical skills assessment. |
| Intervention | Four videos of one mock OSCE station will be produced. A professional actor plays a medical student. Two near-identical scripts are prepared. Two videos show the actor speaking with an Indian accent and two videos show the actor speaking without the accent in either script. UK OSCE examiners will be recruited online and randomly assigned to two groups. They will watch two videos online, each with either script, with and without the Non-Native English Accent. For each video performance, examiners will be asked to give an individual score to each checklist item and a global score. Randomisation: alternating group number allocated in the order the consent forms are received. |
| Intervention type | Other |
| Primary outcome measure(s) |
Global scores and individual item scores given by the OSCE examiners at the time of watching the video. |
| Key secondary outcome measure(s) |
None |
| Completion date | 30/04/2019 |
Eligibility
| Participant type(s) | Health professional |
|---|---|
| Age group | Adult |
| Sex | All |
| Target sample size at registration | 100 |
| Total final enrolment | 42 |
| Key inclusion criteria | OSCE examiners in the UK who have had formal OSCE examiner training |
| Key exclusion criteria | Does not meet inclusion criteria |
| Date of first enrolment | 13/03/2019 |
| Date of final enrolment | 27/03/2019 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
Barts and The London School of Medicine & Dentistry
Garrod Building
Turner Street
London
E1 2AD
United Kingdom
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan summary | Available on request |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request from An Kozato, a.kozato@smd15.qmul.ac.uk , type of data will be the anonymised participants' raw data. The data will become available upon the request. The raw data will only be made available for the purpose of academic research and the request shall be made to the author directly. Consent regarding the use of personal data has been obtained from participants under the condition of any identifiable information to be removed. The participants are assigned a numerical ID and any identifiable information such as personal contact information will be removed from the raw data. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 15/08/2020 | 06/10/2020 | Yes | No |
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
Editorial Notes
06/10/2020: Publication reference added.
15/04/2020: Trial’s existence confirmed by Queen Mary Ethics of Research Committee
