The OSPE is a close cousin of the Objective Structured Clinical Examination, the OSCE that has become the gold standard for assessing clinical skills in medical licensing worldwide. Both formats break an assessment into a circuit of timed stations, each targeting a specific skill or piece of knowledge. Instead of one examiner watching a student perform an unstructured practical task, students rotate through stations where the questions, the specimens, the scoring rubrics, and often the examiners themselves are standardized. The theoretical promise is compelling: standardization reduces the idiosyncratic biases of individual examiners, structured checklists make grading more transparent, and a broader sampling of the curriculum can be covered in a single exam. But implementing the format well is demanding, and evidence from different institutions has been mixed, which is precisely why the Al-Quds team set out to measure how the format performs in their own integrated preclinical curriculum.

The study design was a within-cohort comparison with repeated measures, meaning the same students were assessed multiple times under different examination conditions. A total of 315 student records were available for analysis. The cohort first sat a computerized traditional practical examination, or TPE, as part of the Digestive System course. They then completed OSPE-1 in the Endocrine System course and OSPE-2 in the Reproductive System course. Because the same students generated all the scores, the researchers could use paired statistical techniques that control for individual differences in ability, a considerable advantage over comparing separate groups of students. Scores were summarized descriptively and compared using paired-samples t-tests alongside a linear mixed-effects model with student identity as a random intercept, a modern approach that accounts for the fact that repeated observations from the same person are not statistically independent.

The performance findings were subtle rather than dramatic. On OSPE-1, covering the endocrine system, students averaged 6.16 out of a maximum score, with a standard deviation of 1.69, based on 313 valid scores. That was significantly lower than their average of 6.62 on the traditional practical examination, which had a standard deviation of 1.61 across 314 scores. The paired analysis put the mean difference at minus 0.47 points, with a 95 percent confidence interval running from minus 0.68 to minus 0.26 and a p-value below 0.001, indicating the drop was unlikely to be a statistical fluke. Yet on OSPE-2, covering the reproductive system, the picture changed. Students averaged 6.79 with a standard deviation of 1.55 across 311 scores, and the mixed-effects model found no significant difference from their traditional exam performance. In other words, whatever initial dip the structured format produced seemed to disappear the second time around.

One plausible reading of that pattern is a learning-curve effect. The first OSPE a cohort encounters is not just a test of endocrine knowledge; it is also an unfamiliar test format, with new timing rules, new station logistics, and new expectations about how to demonstrate competence. By the second structured exam, students had already navigated the circuit once, and their scores rebounded to match or exceed their traditional exam baseline. Correlations between the different assessment occasions were positive but only weak to moderate, which the researchers interpreted cautiously as exploratory associations rather than firm evidence about how performance in one format predicts performance in another. That caution is characteristic of the paper as a whole, and it is one of its most scientifically valuable features.

Indeed, the authors are unusually explicit about the limits of their own design. Because the traditional exam and the two OSPEs were embedded in different courses covering different body systems at different points in the academic year, examination format was confounded with course content, timing, and the natural progression of the students themselves. A lower score on OSPE-1 could reflect harder material, less accumulated study time, or the novelty of the format, and the study cannot disentangle those possibilities. The researchers therefore frame their results as within-cohort performance comparisons across assessment occasions, not as causal evidence that one examination format is superior to the other. In an era when assessment research is often oversold, that kind of interpretive discipline matters, and it gives the perception data that follows a firmer footing.

That perception data came from a 16-item questionnaire using a five-point Likert scale, completed by 140 of the students, a response rate of 44.4 percent. The responses were generally favorable on the dimensions that matter most to assessment designers. Students reported positive views of the objectivity of the OSPE, the clarity of its instructions, its value as a teaching and learning tool, and its role in building confidence. These findings align with the core rationale for structured assessment: when students believe an exam is fair and transparent, the exam itself becomes a learning experience rather than merely a gatekeeping exercise. The perception that stations sample the curriculum systematically may also encourage broader study habits than traditional practicals, where students can sometimes predict which specimens or demonstrations will appear.

But the questionnaire also surfaced consistent frustrations. Concerns about station timing were common, with students feeling the minutes allotted at each station were tight. Emotional stress and fatigue were also frequently reported, a reminder that a circuit of many timed stations is physically and psychologically demanding in a way a single long practical session is not. These complaints are echoed across the international OSCE and OSPE literature, and they point to concrete design levers: adjusting station durations, building in rest intervals, familiarizing students with the format through formative practice circuits, and monitoring the cognitive load that rapid station-to-station transitions impose. The Al-Quds findings suggest that such refinements could preserve the perceived fairness of the format while softening its stress burden.

The study also carries significance beyond its immediate findings because of where it was conducted. Medical education research from institutions in the Middle East and other underrepresented regions remains comparatively scarce in the global literature, even as those institutions rapidly adopt competency-based frameworks. Al-Quds University’s Faculty of Medicine runs an integrated preclinical curriculum, and this study represents one of the systematic local evaluations of whether structured practical assessment fits that context. The authors, drawn from the university’s Physiology and Pharmacology, Medical Laboratory Sciences, and Microbiology and Immunology departments, note that the research was reviewed by the institution’s Research Ethics Committee and determined exempt from formal approval because it involved non-identifiable data, with informed consent obtained from all participants and no competing interests declared.

Where does this leave the OSPE? The Al-Quds results support continued adoption and refinement rather than a verdict. The authors call for future studies using equivalent examination blueprints across formats, counterbalanced designs in which different student groups take different formats first, and station-level psychometric analyses that can evaluate the validity and reliability of individual stations rather than whole-exam scores. Those methodological upgrades would allow the field to move from asking whether students like the OSPE, which they largely do, to demonstrating precisely when and how it measures competence better than the traditions it replaces. For now, the message from Jerusalem is measured and useful: structured practical examinations can win student trust and hold their own on scores, provided educators treat the first exposure as a learning experience in itself and keep refining the machinery of the format with the same rigor they demand of the students walking the stations.

Subject of Research: Comparison of Objective Structured Practical Examination and traditional practical examination performance and student perceptions among third-year medical students

Article Title: Evaluating student performance and perceptions in objective structured practical examination compared with traditional practical examination among third-year medical students: a within-cohort study at al-quds university

Article References: Rahhal, A., Atallah, A. H., Ghannam, I. A., & Ibrahim, M. A. (2026). Evaluating student performance and perceptions in objective structured practical examination compared with traditional practical examination among third-year medical students: a within-cohort study at al-quds university. BMC Medical Education. https://doi.org/10.1186/s12909-026-10572-5

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10572-5

Keywords: OSPE, medical education, assessment, student perception, practical examination, within-cohort study, Al-Quds University, competency-based education, psychometrics, preclinical curriculum, exam stress, BMC Medical Education

The research team’s starting point was a practical one. As medical curricula increasingly incorporate new technologies, educators need evidence about whether those technologies actually help students learn, and whether students themselves would embrace them. To that end, the Drexel group built a database of virtual 3D scanned prosections—cadaveric specimens that have been professionally dissected for teaching purposes and then captured as digital three-dimensional models—for students to use while studying gross anatomy. Prosections are a precious and finite resource: each one requires hours of skilled dissection, and the supply of donor bodies is limited. A high-fidelity digital replica, by contrast, can be viewed by unlimited numbers of students, at any time, from any location, without degrading.

To test whether the digital versions could stand in for the real thing, the researchers recruited twenty-nine incoming first-year medical students before they had begun formal anatomy coursework. The participants were divided into two groups: fifteen students would be taught using physical prosections of the external heart, and fourteen would learn from virtual 3D scans of the same prosections. The study was deliberately structured in four stages, allowing the team to measure learning gains with unusual rigor for an educational technology trial.

First came a pre-test, administered to all participants, that used both physical prosections and images of the virtual 3D scans to probe what the students already knew about external heart anatomy. Then each group received a teaching session using its assigned modality—the physical group handling and studying the actual dissected hearts, the virtual group working with the 3D scanned models. Immediately afterward, all students took a post-test identical to the pre-test, again assessed on both physical specimens and digital images. Finally, every participant completed a survey about their experience and attitudes toward the technology.

The exam results delivered the study’s headline finding: both groups improved dramatically, and neither format held an advantage. Students taught with physical prosections raised their scores to an average of 42.6 percent, with a standard deviation of 17.9, while students taught with the virtual 3D scans reached an average of 44.3 percent, with a standard deviation of 24.0. The difference between the groups was not statistically significant, but the improvement within each group was, with post-test scores rising significantly above pre-test baselines regardless of whether students had prior anatomy experience. In other words, the digital models taught anatomy just as effectively as the cadaveric specimens they replicated—a result that carries real weight given how often virtual resources are dismissed as inferior substitutes.

Perhaps more striking was what students believed about the technology after using it. Those who had learned with the virtual 3D scans were significantly more likely to agree with the statement that they would be able to sufficiently learn anatomy using 3D scans, rating their agreement at 4.1 on a Likert-type scale compared with 3.0 among students taught with physical prosections. First-hand experience with the digital resource, it seems, converted skeptics into believers. Confidence in one’s own learning is not the same as learning itself, but the alignment of subjective confidence with objective performance in the virtual group is exactly the pattern educators hope to see when introducing a new tool.

Yet the survey also revealed a firm boundary to students’ enthusiasm. Regardless of which group they had been assigned to, participants disagreed with the idea that they would have a similar laboratory experience if they learned from 3D scans instead of dissection—the physical group averaging 2.1 and the virtual group 2.5 on the agreement scale. The dissection laboratory, it appears, offers something the students regard as irreplaceable, whether that is the tactile engagement with real tissue, the ritual of working with a donor body, or the collaborative culture of the anatomy lab itself. This finding echoes a long tradition in medical education scholarship that frames dissection not merely as a means of learning structures but as a formative professional experience in its own right.

At the same time, students saw a clear and valuable role for the digital resource alongside traditional teaching. Both groups agreed that they would use the virtual 3D scans to prepare for the dissection laboratory and for practical and written examinations, with ratings of 4.5 in the physical group and 4.9 in the virtual group. Rather than viewing the technology as a replacement, the students positioned it as a complement—a way to preview structures before entering the lab, review them afterward, and study at times when the laboratory is closed and the prosections are locked away. This blended model aligns with a broader trend in anatomy education, where meta-analyses of three-dimensional visualization technologies have generally found modest but real learning benefits when such tools are integrated with, rather than substituted for, conventional instruction.

The context for this study matters. The COVID-19 pandemic forced anatomy courses around the world online almost overnight, accelerating adoption of virtual and augmented reality resources and prompting a wave of research into their effectiveness. Surveys of anatomy education before and during the pandemic documented a rapid, sometimes chaotic shift toward digital delivery, and questions about the appropriate balance between cadaveric and digital learning have remained contentious ever since. Studies of computer-generated three-dimensional models, immersive virtual reality, photogrammetry-based training tools, and web-based interactive visualization have produced a mixed but increasingly encouraging picture, with the Drexel results adding a rare head-to-head comparison using authentic scanned prosections rather than idealized computer renderings.

The study’s authors are careful about what their data can and cannot show. With twenty-nine participants, the sample is small, and the standard deviations—especially the wide spread of 24.0 points in the virtual group—indicate considerable variability in how much individual students gained from each format. The subject matter, the external heart, represents one region of gross anatomy, and results might differ for more spatially complex regions such as the temporal bone or the brachial plexus. The students were also tested immediately after teaching, leaving open questions about long-term retention. Still, the core conclusion is difficult to dismiss: on a practical examination, virtual 3D scans of prosections performed on par with the physical specimens from which they were made.

For medical schools weighing expensive investments in digital anatomy infrastructure, the message is nuanced but actionable. Virtual 3D prosection databases can serve as legitimate learning tools, capable of producing measurable gains in anatomical knowledge equivalent to those achieved with physical specimens, and students who use them come away confident in their value. But the same students who endorse the technology also insist that it should not replace the dissection laboratory itself. The future of anatomy education, if the learners have their say, is not digital versus cadaveric but digital and cadaveric—scanned hearts on the screen before the exam, real ones on the table in the lab, and a generation of physicians trained with the best of both.

Subject of Research: Comparing the effectiveness of virtual 3D scans and physical cadaveric prosections for teaching external heart anatomy to medical students

Article Title: A Practical Examination and Feedback Survey Evaluating Learners Taught Using Physical Prosections vs. 3D Models of Prosections of the External Heart

Article References: Waldman, S. A., Sejdiu, Z., O’Hara, S. M., Shumsky, J. S., & Howe, C. A. (2025). A Practical Examination and Feedback Survey Evaluating Learners Taught Using Physical Prosections vs. 3D Models of Prosections of the External Heart. Frontiers of Digital Education, 2(3), Article 27. https://doi.org/10.1007/s44366-025-0064-9

Image Credits: AI Generated

DOI: 10.1007/s44366-025-0064-9

Keywords: anatomy education, medical education, 3D scanning, prosections, gross anatomy, virtual dissection, heart anatomy, cadaveric specimens, student performance, digital learning, Drexel University, practical examination