OSCE/Online Practical Exam

An Objective Structured Clinical Examination (OSCE) allows students to demonstrate their skills in a clinical scenario.

The OSCE is a series of exam stations that students complete. They spend a specific amount of time on each station, allowing examiners to assess clinical skills and clinical reasoning abilities (Daniels & Pugh, 2018).

When to use an OSCE

OSCE is a useful type of assessment when you want students to demonstrate competency in:

  • clinical performance
  • sourcing and interpreting data
  • problem solving
  • communicating
  • handling unpredictable patient behaviour.

  • Innovative learning experience.
  • Assesses a broad range of knowledge and problem-solving, communication, decision-making and patient management skills.
  • Allows students to interact and receive personalised feedback.
  • Recording the session allows the student to reflect on and improve their performance.
  • Allows assessment of many students at a given time in a rotation pattern.
  • Can be stressful for some students.
  • Requires organisational training, infrastructure and resources.
  • 'Textbook' scenarios may not imitate real-life situations.
  • Authenticity can be questionable.
  • Compartmentalises student knowledge and skills.

How to develop an OSCE

Follow these steps to develop an effective OSCE assessment.

Step 1


Decide the task and skills to be examined.

Step 2


Create a blueprint. For example, if the goal is to assess clinical skills then the blueprint should include stations that reflect that. This helps to ensure that one can generalise performance on these stations to the learner’s ability to perform other history and physical examinations in an OSCE.

Step 3


Decide the number of stations needed. Ten to fifteen stations are ideal, with 6-10 minutes allocated per station.

Step 4


Develop a case that represents the clinical problem you want students to overcome.

Consider details such as:

  • scenario presentation
  • the task
  • how long it will take to complete the task.
Step 5


Make sure all resources for the OSCE are in place, including a marking rubric. Develop the rubric as a checklist or a rating scale.

Scoring can be dichotomous (e.g. did or did not do) or polytomous (e.g. done well, attempted but not done well, not done).

Step 6


Prepare staff and helpers:

  • Train OSCE evaluators, explaining:
    • the purpose of the OSCE
    • expected student skill level
    • how evaluators should interact with students.
  • Provide relevant information to timekeepers and patients/volunteers if relevant. A sample rubric can also be helpful.
Step 7


Determine the day/period of exam or allocate individual times to students.

Step 8


Review the arrangement of the exam. Consider taking help from a subject matter expert/colleague to make sure the OSCE reflects the desired learning outcome.

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