Development and Reliability of an Objective Structured Clinical Examination for Intake Interviews in Mental Health Occupational Therapy Education

Introduction: Evaluating clinical competencies in mental health occupational therapy is essential but is hampered by a lack of standardized assessment tools. Intake interviews are particularly challenging to assess because of their interpersonal and observational nature. This study aimed to develop an Objective Structured Clinical Examination (OSCE) for intake interviews in mental health occupational therapy education and to examine its reliability. Methods: This cross-sectional study included 60 third-year occupational therapy students from two Japanese universities. Each student completed one OSCE station using one of three standardized patient scenarios based on common psychiatric presentations. A 16-item, behaviorally anchored rating scale across three domains (attitudes, skills, evaluation) was used. Two occupational therapists independently scored performance. Internal consistency was assessed using Cronbach's alpha, and inter-rater reliability using intraclass correlation coefficients. Agreement on total scores was examined using Bland-Altman analysis. Results: Internal consistency was high for all domains (Cronbach's alpha = 0.850-0.887) and for the total scores (alpha = 0.816 and 0.817). Inter-rater reliability ranged from moderate to excellent across domains (ICC = 0.670-0.900) and was substantial for the total score (ICC = 0.854, p < 0.001). Bland-Altman analysis showed a small mean difference between raters and narrow 95% limits of agreement. Discussion: This OSCE demonstrated high internal consistency and acceptable inter-rater agreement in assessing complex competencies such as empathy and professionalism. By translating abstract interpersonal skills into observable behaviors, it may provide a practical framework for structured formative feedback. Further studies with larger and more diverse samples are needed to establish its validity and broader applicability.