As a course leader for pharmacy, I see firsthand how Objective Structured Clinical Examinations (OSCEs) can transform student learning and assessment. Originally developed for healthcare education, OSCEs could prove their value far beyond their traditional roots - offering a powerful, authentic alternative to written exams, especially in an age where AI is reshaping how students engage with assessments.
What exactly is an OSCE?
An OSCE is a practical, station-based assessment where students rotate through a series of timed scenarios designed to test specific skills and knowledge. Each station focuses on a particular task - such as taking a patient history, interpreting clinical data or conducting a physical examination on a patient, while being observed and assessed by an examiner using a structured marking scheme. This format allows for the evaluation of both technical and interpersonal competencies in a controlled, repeatable and objective way (Zayyan, 2011).
Bridging the gap between learning and doing in pharmacy education
In pharmacy education, OSCEs are a cornerstone of our approach to assessing competence. They allow us to evaluate not just what students know, but how they apply that knowledge in real-world scenarios. This aligns with Miller’s Triangle (Miller, 1990), particularly the upper levels - “shows how” and “does” - which are essential for preparing students for professional practice.
In the department, I led the design of several modules, aligning teaching materials and teaching sessions with OSCE assessment structures. This ensures students are not only prepared for the exam but also for the realities of pharmacy practice. The result? A significant improvement in student outcomes: our first attempt pass rate rose from 59% to 79% and this year to 87%.
Students have commented after an OSCE: “I really enjoyed the OSCE, especially the interactive elements,” and “The workshops and simulations during the year helped me with the OSCE stations and I felt more confident.” This kind of feedback reinforces the value of this approach - not just as an assessment, but as a learning experience.
Are OSCEs an inclusive assessment?
OSCEs can be inclusive assessments when thoughtfully designed. Their structured format helps reduce bias and ensures consistency, offering all students a fair opportunity to demonstrate competence. However, challenges such as cultural bias, marker subjectivity and stress-related impacts, especially for neurodiverse students, can affect inclusivity.
Designing effective OSCEs is a team effort. I mentor colleagues in creating stations and review stations to ensure they reflect diverse patient experiences. To build capacity, I pair experienced assessors with newer staff for marking and moderation. Briefings are provided for markers and actors prior to the OSCE. This not only ensures consistency but also supports professional development.
It is critical to note that although OSCEs are a competence-based assessment, in my department we incorporate reasonable adjustments for students with specific needs, for example, by providing large print materials or tablet devices to access resources.
Balancing the demands
It is true that OSCEs are resource intensive. They require time, space, trained assessors and careful planning. However, with the use of electronic marking schemes, we have significantly reduced the post-assessment marking burden. Real-time digital scoring allows for immediate feedback and streamlines moderation.
The investment pays off. OSCEs provide rich data on student performance, support inclusive practices and foster deeper learning. They also prepare students for the realities of professional life - where competence is not necessarily measured by how well you write an essay, but by how effectively you act in the moment.
OSCEs across disciplines: a new frontier
Imagine a law student presenting a legal argument in a simulated courtroom, or a business student pitching a marketing strategy to a panel of clients (actors). They embody the core elements of OSCEs: structured, scenario-based assessments that test applied knowledge and interpersonal skills under time constraints. In disciplines like education, social work, engineering and even the arts, OSCE-style assessments can evaluate competencies such as communication, ethical reasoning, teamwork and decision-making. These are areas where traditional essays or multiple-choice exams may fall short. In the age of generative AI, where students can outsource written work, OSCEs offer a safeguard. They require students to think on their feet, interact with others and demonstrate their abilities in real time. This makes them a more authentic and AI-resilient form of assessment.
Adapting assessment
As educators, we must ask if our assessments are preparing students for the world they are entering. In a rapidly changing landscape, OSCEs offer a way to bridge the gap between theory and practice - not just in healthcare, but across higher education.
How might you adapt OSCE-style assessments in your own discipline? What skills could you assess more authentically through simulation and interaction?
Dipa Kamdar is a Senior Lecturer in Pharmacy Practice at Kingston University, where she leads on equity, diversity and inclusion, OSCE design for first year students and inclusive assessment practices.
References:
Miller, G.E. (1990) ‘The assessment of clinical skills/competence/performance’, Academic Medicine, 65(9), pp. S63–67.
Zayyan, M. (2011) ‘Objective structured clinical examination: the assessment of choice’, Oman Medican Journal, 26(4), pp. 219-222. (Accessed: 02 July 2025).