The value of using the objective structured clinical examination (OSCE) as a determinant of clinical skills is widely agreed. It is the preferred way to assess clinical skills across a variety of programmes, such as medical, pharmacy, veterinary and so on and as such, is considered a more robust approach to clinical skills assessment in comparison to the short or long case. Its wide adoption across disciplines and international boundaries supports the agreement of its high utility, particularly in terms of reliability and validity. However, for the vast majority of institutions, running OSCEs has a high associated cost – both directly and indirectly.
Given the pressure on education budgets, there certainly is a strong case for reducing these costs –making OSCEs more cost effective, whilst not compromising any aspects inherent in the assessment method, especially given the risks of passing an incompetent doctor for example. A study by Brown et al in 2015 identified that it costs over £65,000 to run a high stakes OSCEs – this was a 15 station OSCE held over 2 days for 185 students. Adding in indirect costs this increases the cost to above £80,000.
The study identified that the large bulk of the costs were fixed due to the nature of the assessment – and these are the costs associated with examiner time on the day of the exam as well as those of standby examiners. The second most costly item is the non-examiner staff time required for the development, administration and production of exam tasks.
With the aid of robust exam management software that delivers eOSCEs, it is possible to reduce the non-examiner costs associated with running OSCEs – although of course the reduction in costs is going to be less due to the different pay scales associated with administrative staff compared with medical examiners. However, with the inclusion of opportunity cost associated with staff being able to focus on other tasks rather than exam administration, the savings will look more attractive – especially when considering that each School may run up to 5 OSCEs per year.
So what functions should good exam management software perform that will reduce the amount of time administrative staff dedicate to running OSCEs?
Improving the cost effectiveness of OSCEs is just one consideration when choosing software to streamline OSCEs. Other reasons include strategic considerations such as aligning with digital strategies so that assessments reflect the real world scenarios as closely as possible for example, convenience, meeting student expectations for a digital exam taking and integrating with other systems and processes.