Summative OSCEs in undergraduate medical education

Making judgements on the competency of our peers and trainees is important in patient healthcare. Inaccuracies in such judgements could place patients at risk. First described in 1979, Objective Structured Clinical Examinations (OSCEs) have become one of the most widely used methods of assessing aspects of clinical competency in healthcare education. This method of assessment was originally developed in order to address the unreliability and lack of generalisability of traditional forms of clinical assessment such as the long case. The overarching philosophy in OSCEs is that all candidates are presented with the same clinical tasks, to be completed in the same timeframe and are scored using structured marking schemes. Compared to the long case, OSCEs reduce bias relating to the type of clinical case selected and who performs the assessment. Ideally the only variance in an OSCE should be the candidate’s performance. In formative forms of assessment the main purpose is to provide feedback to the student. Summative forms of assessment define those who have achieved a passing standard and can progress in their studies. This article aims to provide a review of summative OSCEs in undergraduate medical education.