What is an OSCE? Find out all you need to know about the exam.

The Objective Structured Clinical Examination or OSCE is a multipurpose evaluative tool that can be used to assess the competence of healthcare and clinical workers on a variety of skills and tasks.

The OSCE uses objective based testing to assess competency through direct observation.

It gives an easily reproduced and uniform way of testing multiple students within a clinical setting.

An OSCE gives students a hands-on, real world approach to learning and assessment within a classroom environment – this helps keep students engaged and give a better understanding of the decision making processes and challenges experienced in real world environments.

---

What is OSCE EXAM?

An OSCE, which stands for Objective Structured Clinical Examination, is a form of evaluation used in medical education to assess the clinical skills and competency of medical students or healthcare professionals.

It aims to determine whether students or professionals can apply their medical knowledge and clinical skills in simulated, real-world situations.

Why is the exam useful?

Objective

• Same scenarios for all: OSCE in medical uses the same situations for every student. This is more fair than different questions.
• Clear criteria: Skills get marked against set steps. This is more objective than personal opinions.
• Multiple examiners: Having 2 or more examiners per station adds consistency in scoring.

Structured

1. Organised stations: Each OSCE station focuses on 1 skill. This is efficient compared to mixing skills.
2. Time limits: The fixed time frame per station is equal for everyone. Some don’t get more time.
3. Controlled setting: OSCEs use the same consistent conditions. This avoids random factors affecting the exam.

Clinical

1. Simulated situations: OSCE patients and scenarios are like real clinical practice. Students apply knowledge.
2. Focus on skills: OSCEs test practical clinical skills like exams, diagnosis and communication. Not just theory.
3. Relevance to practice: The real-world format prepares students for actual patients. It connects learning to real use.

Examination

1. Formal evaluation: OSCEs formally measure competence against standards.
2. Multiple stations: Covering different skills gives a full picture of abilities.
3. Feedback and improvement: Scores and examiner feedback help students identify and improve weaknesses.

What’s in an OSCE Station?

OSCE stations are the individual skills tests that make up the full exam. Here are the key parts of each station:

• Scenario: Gives context and details about a sample patient case. Helps set up the skill to test.
• Instructions: Clear direction for students on what tasks to do in the time limit.
• Checklist: The steps students should follow to show skill. Used for scoring.
• Rating scales: Measures overall performance in areas like communication. Gives qualitative feedback.
• Time limit: Enough time for a competent student to finish. Tests efficiency.
• Equipment: Any items needed to do the required tasks.
• Simulated patient: An actor playing the role of patient, if needed. Makes the scenario realistic.
• Assessors: Staff trained to rate students accurately and without bias using checklists.

Careful design of each part is key. This ensures the station reliably tests the clinical skill it was created to assess.

Short History of OSCE in Medical Field

OSCEs were first developed in the 1970s by Dr. Ronald Harden at Dundee University in Scotland.

They were created to address the shortcomings of traditional long and short case medical examinations, which were highly subjective and inconsistent. OSCEs introduced more objectivity, structure, and uniformity to clinical assessments.

Since then, OSCEs medical have been widely adopted in medical schools and healthcare professions education programs globally as a reliable and valid evaluation method.

They are now considered one of the most robust and objective means of gauging learners’ clinical abilities.

What Happens During an OSCE Exam?

OSCE Exams evaluate not only medical knowledge but also an array of practical clinical skills – including communication, diagnostic, examination, procedural, record-keeping, patient education, and management skills.

During a typical OSCE, students rotate around a circuit of stations that test various skill sets. At each station, students are presented with a clinical scenario and asked to perform tasks within a specified time limit – usually 5 to 15 minutes per station.

Scenarios could involve interacting with standardized patients (people trained to portray patients), models, mannequins, photographs, lab reports, notes, patient charts, etc.

As students undertake the clinical tasks, examiners assess and grade them on standardized checklists or global rating scales.

Stations can have different formats to evaluate varied competencies:

• Clinical encounter stations – assessing interaction/communication with patients
• History taking stations – evaluating students’ ability to gather clinical history from patients
• Physical examination stations – testing examination skills and findings
• Procedural skill stations – observing techniques for procedures like insertion of IV lines
• Data interpretation stations – assessing interpretation of investigation reports, images
• Patient management stations – testing clinical decision making and management planning
• Record keeping stations – evaluating progress note charting skills
• Patient education stations – assessing patient counseling skills

A single OSCE Exam will have multiple stations; lengths vary based on the purpose – formative or summative. Summative high-stakes exams can have up to 20 or more stations to test a broad range of skills robustly.

OSCEs also incorporate different kinds of simulated patient scenarios – some involving mannequins and models, others using simulated/standardized patients. This allows the assessment of both technical and interpersonal aspects of clinical competence.

The examiners grading students rotate as well, to reduce examiner bias.

Students are graded simultaneously by two independent assessors per station whenever feasible.

The final OSCE score is an aggregate derived from students’ performance ratings across all stations on various assessment domains/metrics.

The basic steps in modelling an OSCE exam include:

• Determination of the OSCE team.
• Skills to be assessed (OSCE Stations).
• Objective marking schemes
• Recruitment and training of the standardized patients.
• Logistics of the examination process.

Multiple OSCE stations will test delegates on a variety of skills throughout the day as they move from one task to another in a university environment.

However, due to the nature of how we operate and the demands of our clients we offer them course specific at the end of a day of theory based training.

The students will complete the OSCE on a one to one basis with the trainer, they can take anywhere from 5 to 15 minutes each and are pass or fail.

In addition, we will give students who fail time to re-read and practice while we assess others before they retake the OSCE.

We will give a maximum of 3 attempts to pass before officially failing a student.

Why are OSCE Exams Used?

OSCE have become common in medical programs across the globe due to the manifold advantages this structured, performance-based format offers:

1. Objectivity: OSCEs enable the standardized, structured assessment of clinical skills, ensuring all students undertake similar tests under identical conditions. This makes OSCEs highly objective.
2. Comprehensiveness: OSCE circuits cover diverse stations testing history-taking, communication, examination, procedural activities, etc. This allows extensive sampling of students’ clinical capabilities.
3. Reliability: Multiple OSCE stations testing key skills adequately sample student competence reliably. A high degree of inter-rater reliability between examiners can also be achieved via assessor training.
4. Validity: OSCEs demonstrate strong content and construct validity in measuring clinical competencies expected of clinicians. Simulated scenarios also offer reasonable fidelity, enhancing the authenticity.
5. Practical focus: OSCEs emphasize the application of applied knowledge and demonstration of practical clinical skills essential for delivering patient care.
6. Immediate feedback: As OSCE stations provide real-time evaluation, students receive instant constructive feedback to identify and address deficiencies.
7. Standardized assessment: Checklists and rating scales establish standardized criteria for measurement across all examinees, unlike traditional long/short cases.
8. Feasibility: OSCE delivery is logistically feasible and cost-effective, especially with sequential testing of students.

What is the purpose of an Objective Structured Clinical Examination?

The purpose of an Objective Structured Clinical Examination, OSCE is to make sure healthcare professionals have the right abilities to provide safe and effective care to patients.

It’s a fair way to assess skills and keep a high standard in healthcare education and practice.

Medical and nursing fields often utilize OSCEs to assess candidates’ skills, knowledge, and communication abilities.

In addition, during an OSCE, candidates progress through different stations, where they encounter various scenarios and tasks. Each station has specific things they look for and trained assessors evaluate the candidates.

How OSCE Exams Are Created

Making a good OSCE exam takes careful planning and work. There are 6 main steps:

1. Blueprinting

First, the skills and abilities to test are picked. These are used to decide how many stations and what kinds are needed.

2. Writing Stations

Next, experts write challenging cases and checklists for each station. Simulated patients also practice.

3. Review and Revision

Other experts review the stations to make sure they are clear, fair and matched in difficulty. Changes are made based on feedback.

4. Dress Rehearsal

A test run of the full exam is done with teachers acting as students. This catches any last issues. Timing per station is also set.

5. OSCE Delivery

On exam day, students rotate through the stations within the time limits. The prior planning makes sure things run smoothly.

6. Rating and Analysis

Afterwards, student performance is rated. Analyses check that the exam was reliable and valid. The results help make future exams even better.

Creating a good OSCE takes rigorous planning, testing and review. This ensures students are evaluated fairly and accurately on clinical skills.

OSCE Station Examples

Having understood the critical pieces of an OSCE station, consider a few illustrative examples across skills:

● History-taking station: The student enters an examination room with a standardized patient portraying a man complaining of progressive fatigue, nausea and heartburn. Documentation provides additional background. Students have 5 minutes to gather a focused clinical history addressing relevant aspects that should be covered as outlined in a checklist. Students are rated on their interpersonal skills and completeness of medical history obtained.

● Physical exam station: Students enter a room to find a simulated model of an abdomen with ascites. The scenario states vital details. Students have 7 minutes to demonstrate abdominal assessment – inspecting, palpating, auscultating and percussing as warranted and stating salient findings. An examiner rates students against the key maneuvers to be exhibited via a checklist.

● Clinical decision-making station: Students are given 5 minutes to study a lab report, chart and patient description showing electrolyte imbalance and are asked to document a differential diagnosis, investigations needed and initial management for the problem portrayed. Checklists score students adequacy and appropriateness of responses.

● Patient education station: Students are granted 3 minutes to study a case of newly diagnosed hypertension needing lifestyle counseling. They must then counsel a standardized patient regarding necessary lifestyle modifications and medication adherence education relevant to the scenario. Rating scales assess patient-centeredness, clarity and accuracy of advice.

Constructing numerous similar focused stations allows assessment of varied competencies within a single OSCE.

---

We have clinical training courses and train the trainer courses. Check our courses pages.

---

Preparing for OSCEs as an Examinee

OSCEs undoubtedly evoke significant anxiety amongst students due to the high-stakes nature regulating progress decisions. However, systematic preparation can enhance OSCE performance, given the structured format enables identifiable areas for students to focus training upon.

Strategic OSCE preparation tips include:

1. Know the expected skill sets to be assessed – communication, diagnostic, examination procedural, documentation skills
2. Analyze previous OSCEs to discern commonly tested scenarios and skill domains
3. Ensure strong fundamental knowledge relevant to likely scenarios
4. Master expected key psychomotor procedures likely to be assessed
5. Practice integration and application of knowledge to scenarios via self-directed learning
6. Undertake deliberate skills training for communication with standardized patient-actors
7. For high-stakes exams: Perform numerous simulation practice runs on mock OSCE circuits

While such immersive preparation is undoubtedly demanding for students already stretched for time, it can dramatically boost readiness to tackle the complex assessment OSCEs represent by eliminating unpleasant surprises.

Communication Skills for Medical Student Exams

Good communication is a very important skill for all doctors and nurses. During an OSCE exam, you will be tested on how well you can talk to and understand fake patients. Here are some key communication skills to practise:

1. Body Language:

• Keep eye contact to show you are listening
• Have an open, friendly posture and facial expressions
• Be aware of your voice tone and speed

2. Starting the Meeting:

• Warmly greet the patient and say your name
• Make sure you have privacy and the patient feels comfortable
• Find out why the patient is there

3. Listening Carefully:

• Let the patient fully explain without interrupting
• Ask open-ended questions to get more details
• Repeat back the main points to make sure you understood

4. Building Trust:

• Show you understand and don’t judge
• Let them know their feelings make sense
• Use simple words to explain things clearly

5. Asking Questions:

• Ask relevant questions about symptoms, medical history, etc.
• Smoothly switch between open and closed questions
• Avoid questions that could lead the patient’s answer

6. Explaining Things:

• Give clear explanations using an appropriate level of language
• Check if they understand and re-explain if needed
• Involve the patient in deciding next steps

7. Ending the Meeting:

• Summarise the main points you discussed
• Allow time for any final questions or concerns
• Provide clear instructions and next steps before finishing

Good communication is about speaking and listening well. Practise these skills so you can properly talk to patients during your OSCE clinical exams.

How to Book an OSCE Exam

Booking an OSCE medical exam is an important process as it allows you to schedule your objective structured clinical examination. Here is a step-by-step overview:

1. Check Application Deadlines

There are usually set timelines by which you must submit OSCE applications. Check your university/college or licensing body website for exact deadlines relevant to when you hope to take the OSCE. Missing deadlines means you may not get your preferred exam slot.

2. Confirm Exam Eligibility

Ensure you meet all eligibility criteria set by the OSCE administrator – such as completing prerequisite coursework or skills assessments. Submit any documentation needed to demonstrate eligibility.

3. Choose Exam Date

A choice of OSCE schedules may be available, often spanning a few months. Choose your test date thoughtfully factoring in preparation time needed and availability. Book early for maximum flexibility.

4. Register Account

Create an account portal on the exam administrator’s online registration system to manage your OSCE booking application. Follow prompts to fill information.

5. Apply for OSCE

Login to the portal, select your confirmed test date, complete sections gathering necessary data like demographics, submit payment and finalize application submission.

6. Check Status

Track the status of your submitted OSCE booking via your portal. It takes some time to process applications – usually a few weeks or more if documentation needs vetting.

7. Confirmation

Once your exam slot is confirmed, check registered email for the booking confirmation detailing the exam date/center location/start time and pre-exam preparation instructions.

8. Instructions

Follow all pre-exam instructions precisely regarding what items to bring. Failure to follow guidelines about dress code or mandatory items for example, can make you ineligible to test.

That summarizes major steps in securing an OSCE exam booking before you can undertake the assessment. Now let’s consider typical OSCE exam fees:

Objective Structured Clinical Examination Costs

The cost of an OSCE exam can vary depending on several factors, including:

• Location: Costs can differ significantly between countries, universities, and even regional test centers within the same country.
• Organisation: The entity administering the exam may set its own fee structure. This could be a healthcare regulatory body, university, or professional association.
• Type of OSCE: The specific purpose and scope of the exam can influence the cost. For example, OSCEs for initial registration might be more expensive than those for specific skills assessments.
• Number of Stations: Some OSCEs have more stations than others, which can affect the overall cost.

OSCE Exam Costs (UK Pounds)

• Medical school formative OSCE: £80 – £240
• Final year medical school summative OSCE: £240 – £480
• Residency program OSCE: £320 – £640
• Primary care specialty board licensing exams OSCE: £600 – £1600
• Surgical specialty board licensing exam OSCE: £1200 – £4000

The costs can vary within these ranges based on the exact OSCE assessment, administering institution, facilities utilized, examiners hired, materials involved and other overhead costs.

But broadly, OSCE exam fees in British Pounds for students can range from about £80 – £480 depending on whether it is for formative skills assessment or high-stakes final competency evaluation.

Postgraduate trainee physicians undergoing specialty training college examinations should budget between approximately £320 – £4000 to sit for OSCE licensing assessments depending on the scope of the exam and specialty.

What is the difference between OSCE and ISCE?

The main difference between an Objective Structured Clinical Examination (OSCE) and an Integrated Structured Clinical Examination (ISCE) lies in their assessment focus and approach.

During an OSCE, you’ll go through different stations and face different scenarios to show your clinical skills. You might have to do tasks like taking a patient’s history, examining their body, or demonstrating specific skills. OSCEs check if you can follow standard rules accurately.

On the other hand, an ISCE focuses on using your knowledge and skills in real-life situations. It’s about solving complex problems and making important decisions in patient care. ISCEs cover a range of skills related to a common theme, like managing a patient with a specific condition. They want to see how well you can think, communicate, and solve problems in a real clinical setting.

So, in simple terms, OSCEs test specific tasks, while ISCEs check how well you can handle complex situations in healthcare.

Is it hard to pass Objective Structured Clinical Examination?

Passing an OSCE can be challenging due to the rigorous evaluation of clinical skills and knowledge. It requires thorough preparation, practice, and the ability to perform under pressure.

However, with adequate preparation, guidance, and support, many candidates are able to successfully pass the OSCE.

It ultimately depends on an individual’s dedication, readiness, and their ability to demonstrate the required competencies during the assessment.

What is a good OSCE score or what is the minimum required score?

A good score in an OSCE depends on what the school or organisation conducting the assessment considers as passing.

The educational institution or licensing body usually sets the passing score. Its purpose is to ensure that students have shown enough skills and knowledge to provide safe and effective care to patients.

The required score can vary between different schools and may depend on how difficult the exam is or what they’re testing for.

To know what score you need to pass, it’s best to check the guidelines or instructions given by the organisation that’s organizing the OSCE.

They will tell you the score you should aim for to pass the exam successfully.

Objective Structured Clinical Examination Training

We can run OSCE’s in a range of clinical subjects, we have a listed a few of the common areas we regularly cover below. These can have be tailored to result in specific outcomes as determined by the employer, the task and the environment:

• Catheterisation
• Enteral Tube Feeding
• Venepuncture & Cannulation
• Tracheostomy Care
• Syringe Driver & IV Drugs
• Medication Adminstration
• Oral Suctioning
• Bowel Mangement (Enema, Suppository & Manual Evac)
• Ventilation, NIV, CPAP, BIPAP

Caring For Care are able to deliver specific training around a range of subjects culminating in OSCE assessment.

We cover the whole of the UK and deliver the training at a location and time to suit you and your business.

For more information on what we can offer, call 01782 563333 or use the contact form below.

Frequently Asked Questions