Feasibility and implementation of a final year Objective Structured Clinical Examination (OSCE) in a medical model curriculum

Abstract

Practical clinical skills cannot be adequately assessed through written examinations. This article describes the development and implementation of a summative Objective Structured Clinical Examination (OSCE) prior to the Practical Year (PJ) at Hannover Medical School. An interdisciplinary team, medical experts and students developed 34 OSCE stations based on Entrustable Professional Activities. Stations were piloted in 2022 with voluntary student participants and focus group feedback. The PJ-OSCE was curricularly integrated in 2023/24 and linked to five core clinical clerkships/modules. Pass–fail cut scores were established using the modified Angoff method. The pilot OSCEs proved high staffing demands but overall feasible and favorable for student learning. In June 2024, 278 students completed the mandatory PJ-OSCE across 15 circuits of eight stations (8 min each). Mean score was 603.08 (SD 67.57)/800 points (75.2%); pass rate was 97.1%. Examination reliability averaged 0.84 (Cronbach’s alpha, SD 0.06). Students rated the examination 10.90/15 points, with 41.0% reporting substantial learning gains. Examiners rated the format as appropriate (86.3%). This feasibility and implementation study demonstrates that a large-scale summative PJ-OSCE can be successfully developed and delivered within a German model curriculum context. The structured development process may serve as a model for other medical faculties implementing similar examination formats.