Single-Center Study Finds Final-Year Medical OSCE Feasible at Scale

A curriculum-integrated final-year Objective Structured Clinical Examination (OSCE) was feasible at Hannover Medical School, where 278 students completed a mandatory assessment across 15 circuits in June 2024, according to a single-center feasibility and implementation study. The examination had a pass rate of 97.1%, a mean score of 603.08 out of 800 points, or 75.2%, and average internal reliability of 0.84. These results describe the implementation of the examination at one German medical school rather than its performance in other institutions or curricula.

The summative OSCE was conducted before students entered the Practical Year, or PJ, and was linked to five core clinical clerkships and modules. Each circuit contained eight stations, with eight minutes allotted per station. An interdisciplinary team of medical experts and students developed 34 possible stations based on Entrustable Professional Activities.

Pass–fail cut scores were established using the modified Angoff method. The study assessed both the logistical feasibility of delivering a large-scale OSCE and students’ and examiners’ evaluations of the format. The station set was piloted in 2022 with voluntary student participants, with feedback collected through focus groups.

The pilot OSCEs were considered favorable for student learning but demonstrated high staffing demands. Following the pilot, the PJ-OSCE was incorporated into the curriculum for 2023/24 and made mandatory for the 2024 assessment. This staged development process combined interdisciplinary station design, pilot testing, student feedback, curricular integration and formally established cut scores.

Students rated the mandatory examination at 10.90 out of 15 points, and 41.0% reported substantial learning gains. Examiners rated the format as appropriate in 86.3% of responses. The 97.1% pass rate indicates that nearly all participating students met the established standard, while the mean score of 603.08 points characterizes the cohort’s overall performance.

Because the study was conducted at one institution, the results do not establish how the OSCE would perform under different class sizes, staffing arrangements or educational structures. The findings provide a practical example of embedding a large summative clinical examination within a German model curriculum. The reported outcomes support the feasibility of the developed PJ-OSCE at Hannover Medical School, including its delivery across 15 circuits and its integration with five clerkships or modules.

At the same time, the pilot’s high staffing demands remain a documented constraint. The authors concluded that the structured development approach may serve as a model for other medical faculties implementing similar examinations, but the study does not demonstrate that the same format, thresholds or outcomes would transfer directly to every medical school.

Subject of Research: Feasibility and implementation of a curriculum-integrated final-year OSCE in German medical education

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

Article References: Noll, C., Mikuteit, M., Golon, S., Louzek, C., Afshar, K., Just, I., & Steffens, S. (2026). Feasibility and implementation of a final year Objective Structured Clinical Examination (OSCE) in a medical model curriculum. BMC Medical Education, 26(1), Article 1474. https://doi.org/10.1186/s12909-026-10350-3

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10350-3

Keywords: OSCE, medical education, clinical assessment, curriculum implementation, student performance, assessment reliability, medical schools, Germany, Feasibility, implementation, final, year