Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school
Open accessAbstract
Purpose: Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills. This study aimed at investigating the relationships between OSCE grades and current evaluation modalities. Methods: Three-hundred seventy-nine 4 th-year students of University-of-Paris Medical School participated to the first large-scale OSCE at this institution, consisting in three OSCE stations (OSCE#1–3). OSCE#1 and #2 focused on cardiovascular clinical skills and competence, whereas OSCE#3 focused on relational skills while providing explanations before planned cholecystectomy. We investigated correlations of OSCE grades with multiple choice (MCQ)-based written examinations and evaluations of clinical skills and behavior (during hospital traineeships); OSCE grade distribution; and the impact of integrating OSCE grades into the current evaluation in terms of student ranking. Results: The competence-oriented OSCE#1 and OSCE#2 grades correlated only with MCQ grades (r = 0.19, P<0.001) or traineeship skill grades (r = 0.17, P = 0.001), respectively, and not with traineeship behavior grades (P>0.75). Conversely, the behavior-oriented OSCE#3 grades correlated with traineeship skill and behavior grades (r = 0.19, P<0.001, and r = 0.12, P = 0.032), but not with MCQ grades (P = 0.09). The dispersion of OSCE grades was wider than for MCQ examinations (P<0.001). When OSCE grades were integrated to the final fourth-year grade with an incremental 10%, 20% or 40% coefficient, an increasing proportion of the 379 students had a ranking variation by ±50 ranks (P<0.001). This ranking change mainly affected students among the mid-50% of ranking. Conclusion: This large-scale French experience showed that OSCE designed to assess a combination of clinical competence and behavioral skills, increases the discriminatory capacity of current evaluations modalities in French medical schools.
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This level of specificity not only clarifies expectations but also builds learners' confidence in their ability to improve.
“This level of specificity not only clarifies expectations but also builds learners' confidence in their ability to improve [79,80].”
From Formative assessment and feedback in medical education: A practical guide: AMEE Guide No. 189 (2026) · cites this paper as [79]
Objective Structured Clinical Examinations (OSCEs) have become a cornerstone of medical education, offering structured and standardized environments to evaluate clinical skills systematically.
“Objective Structured Clinical Examinations (OSCEs) have become a cornerstone of medical education, offering structured and standardized environments to evaluate clinical skills systematically [79,80,97].”
From Formative assessment and feedback in medical education: A practical guide: AMEE Guide No. 189 (2026) · cites this paper as [79]
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ResultObjective structured clinical examination compared with other forms of student assessment.
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“Consistently with other studies we observed a significantly larger distribution of grades obtained at OSCE compared to grades from other academic evaluation modalities [11].”
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“…in previous studies, the implementation of an OSCE at the school or national level is challenging and requires many practical considerations (Matet et al., 2021; Rahayu et al., 2016; Vargas et al., 2007; Wilby & Diab, 2016), such as recruitment, training, and retention of personnel; test…”
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“It will increase the discriminatory capacity of current evaluation modalities in French medical schools [5] insofar as it has been shown to be an efficient tool to assess the clinical performance of medical students [6].”
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- Authors
- Matet, A., Fournel, L., Gaillard, F., Amar, L., Arlet, J.-B., Baron, S., Bats, A.-S., Buffel du Vaure, C., Charlier, C., De Lastours, V., Faye, A., Jablon, E., Kadlub, N., Leguen, J., Lebeaux, D., Malmartel, A., Mirault, T., Planquette, B., Régent, A., Thebault, J.-L., Dinh, A. T., Nuzzo, A., Turc, G., Friedlander, G., Ruszniewski, P., Badoual, C., Ranque, B., Oualha, M., & Courbebaisse, M.
- Affiliations
- Inserm (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Université Paris Cité (FR)
- Hôpital Necker-Enfants Malades (FR)
- Centre National de la Recherche Scientifique (FR)
- Corresponding author
- Matet, Alexandre
- ORCID
- Matet, Alexandre
- Fournel, Ludovic
- Gaillard, François
- Amar, Laurence
- Baron, Stéphanie
- Bats, Anne-Sophie
- Charlier, Caroline
- Faye, Albert
- Kadlub, Natacha
- Leguen, Julien
- Lebeaux, David
- Malmartel, Alexandre
- Mirault, Tristan
- Planquette, Benjamin
- Régent, Alexis
- Nuzzo, Alexandre
- Turc, Guillaume
- Friedlander, Gérard
- Badoual, Cécile
- Ranque, Brigitte
- Oualha, Mehdi
- Courbebaisse, Marie
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-01-14
- Volume
- 16
- Issue
- 1
- Pages
- e0245439
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC7808634
- OpenAlex
- W3121048865
- Cited by
- 26
- References
- 32
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 3 · 2021: 1
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Agence Nationale de la Recherche (ANR-10-LABX-0017)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Keywords
- OSCE, medical student assessment, clinical competence assessment, clinical reasoning, social skills, multiple-choice tests, student ranking
- MeSH terms
- Clinical Competence, Education, Medical, Educational Measurement, France, Humans, Schools, Medical, Students, Medical
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