The assessment of palpatory and manual osteopathic therapeutic skills presents multiple challenges, particularly in terms of reliability. The added challenge of inter-rater reliability in the cranial field has been considered in osteopathic journals by a number of authors and adds to the difficulty of developing an assessment tool which is sufficiently reliable to be used as part of a university-validated award in the osteopathy in the cranial field. This paper reports the development and implementation of a multi-station, multi-task OSPE that assesses palpatory and treatment skills, specifically in the cranial approach, and includes the teaching team work involved in generating assessment tasks. The development of defined assessment criteria and procedures for implementation of the assessment, with the objective of maximising inter-assessor consistency, and the consistency of the assessment environment for candidates are described. The report also discusses a small-scale ‘blinded’ pilot study of an assessment task that was included in the scheme development to internally test reliability. Observation of the OSPE in action by an external examiner, acting as an independent observer, provided a further means of assuring consistency of the process. We concluded that a multi-station OSPE, in which a range of skills-based assessment tasks were repeated at different stations, with different models and different assessors applying agreed and defined assessment criteria, was a reliable and valid assessment tool for osteopathy in the cranial field. We also concluded that this methodology had potential for enhancing the reliability of other aspects of osteopathic practical skills assessment.
Nicholas Woodhead has been in full-time osteopathic practice in Nottingham (UK) since 1977, and has been actively engaged in teaching osteopathy in the cranial field at the British School of Osteopathy since the 1980s, and more recently at the Wiener Schule fur Osteopathy. He has been course leader for a university validated post-graduate diploma programme in osteopathy in the cranial field and was primarily responsible for the development of this programme, which was subsequently re-validated as a MSc under his leadership. He has previously served on the Council of the General Osteopathic Council (UK), including its' Education Committee, and currently serves on its' Professional Conduct Committee. He also serves as clinical external examiner for the Paediatric Osteopathy MSc programme at Osteopethie Schule Deutchland, Hamburg, and at the Osteopathic Centre for Children, London.