Factors That Influence Residents' Perceived Credibility of Examiners During a Formative OSCE

Introduction: Formative assessment requires effective feedback. Recent studies have demonstrated the importance of considering the learner's perspective as a determinant of feedback effectiveness. Objective: We examined factors affecting residents' perceptions of the credibility of their examiners/feedback providers during a formative OSCE, including examiner demographics. Methods: Following a formative 5-station internal medicine OSCE, residents were randomized to receive feedback with or without scores, and then asked to fill a questionnaire rating the credibility of feedback providers on their final station. Feedback was provided by clinical faculty or standardized patients (SPs). Residents also rated the quality and characteristics of the feedback received, and previous knowledge of examiner. Correlations between feedback characteristics were explored and predictors of credibility were examined through multivariable linear regression. Results: 180 residents participated in the OSCE. Mean credibility of examiners was 4.37 of 5 (with 89% ≥ 4). Credibility was somewhat lower for SP raters compared to faculty, but differences were not significant (4.09 versus 4.41, P  =  .47). Rater and learner demographic variables did not affect credibility on multivariable analysis; however, the following feedback characteristics were significant predictors of credibility: specificity and balance between positive and formative comments. Provision of scores, actual or perceived resident score on station, length of feedback, and pacing did not appear to affect credibility. Perceived quality of feedback was strongly correlated with credibility. Conclusions: Residents rated the credibility of feedback providers highly in this formative OSCE. Characteristics of raters did not affect credibility. Feedback format, including specificity and balance, were associated with higher feedback credibility.