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

BACKGROUND: 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. METHODS: 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. RESULTS: 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%). CONCLUSIONS: 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.