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Is the OSCE a feasible tool to assess competencies in undergraduate medical education?
Abstract
BACKGROUND: The Objective Structured Clinical Examination (OSCE) was introduced by Harden et al. (1975) trying to answer the problems regarding the assessment of clinical competencies. Despite increasingly widespread use of OSCEs, debate continues with arguments as 'why using such a demanding format if other methods are available?' AIM: To review and synthesize evidence on technical and economic feasibility of OSCE in undergraduate medical studies. METHODS: Best Evidence Medical Education methodology was applied by two independent coders to 1083 studies identified by literature search from 1975 until the end of 2008. KEY FINDINGS: The OSCE is a feasible approach to the assessment of clinical competence for use in different cultural and geographical contexts; to assess a wide range of learning outcomes; in different specialties and disciplines; for formative and summative purposes; to assess students a curriculum or an educational intervention; in the different phases of education including the early and later years of the undergraduate curriculum; and in different health care professions. CONCLUSION: Despite being an expensive test format, evidence suggests that the use of OSCE produces reliable results. The study also suggests that one reason for the wide-scale adoption of the OSCE and the feasibility of its use in different contexts and situations is its inherent flexibility in terms of the number of students that can be assessed, the number of examiners included, the type of patients represented and the format of the examination itself, including the length of the examination, the number and duration of stations.
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“OSCEs assess performance through structured activities where candidates demonstrate competencies directly rather than through written communication, making assessment inherently AI-resistant while maintaining authenticity and validity [10].”
From Clinical assessment meets laboratory science: adapting OSCE methodology for authentic biosciences evaluation in the age of generative AI (2025) · cites this paper as [10]
In the citing paper
“Despite its strong educational validity, the educational infrastructure underpinning OSCE is inherently resource intensive. It requires substantial financial investment, complex logistical coordination, trained faculty examiners, and the recruitment, training, and compensation of human standardized patients (HSPs).”
In the citing paper
“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 [80]
In the citing paper
“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 [80]
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Metadata
- Authors
- Patrício, M. F., Julião, M., Fareleira, F., & Carneiro, A. V.
- Affiliations
- University of Lisbon (PT)
- Corresponding author
- Patrício, Madalena Folque
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2013-03-22
- Volume
- 35
- Issue
- 6
- Pages
- 503-514
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2081134712
- Cited by
- 309
- References
- 39
- Citations by year
- 2026: 31 · 2025: 32 · 2024: 34 · 2023: 27 · 2022: 38 · 2021: 25 · 2020: 16 · 2019: 21 · 2018: 15 · 2017: 19 · 2016: 20 · 2015: 17 · 2014: 12 · 2013: 2
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Topics
- Social Sciences › Education › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Social Sciences › Education › Medical Education and Admissions
- Keywords
- OSCE, clinical competence assessment, undergraduate medical education, assessment feasibility, assessment reliability, formative assessment, summative assessment
- MeSH terms
- Clinical Competence, Education, Medical, Undergraduate, Educational Measurement, Feasibility Studies, Humans, Specialization
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