The objective structured public health examination (OSPHE): work-based learning for a new exam

Introduction: Postgraduate education for all healthcare professionals is shifting from traditional knowledge-based models towards competency-based training and assessment. 1 Norcini’s 2003 paper on work based assessment outline’s George Miller’s pyramid framework for assessing competence (see Figure 1) – with knowledge at the base (‘knows’), competence at the next level (‘knows how’), performance above this (‘shows how’) and action (‘does’) at the top. Action is what actually occurs in day to-day practice, while the lower levels are what are more commonly assessed in an artificial examination environment. 2 The Faculty of Public Health (FPH), the standard-setting body for specialists in public health, has addressed the move towards competency-based training in two ways. The first is the development of a new and more detailed curriculum. This links competencies, training outcomes and their assessment to specific stages in training. The second is the the introduction of the new objective structured public health examination (OSPHE), which will be discussed in this paper. The OSPHE targets the ‘shows how’ level of the pyramid – measuring performance in an examination setting