Following a star: Does who you follow in an OSCE station affect your checklist score?

The Objective Structured Clinical Examination (OSCE) has been hailed as the ‘gold standard’ of competence assessment in healthcare.¹ This form of assessment is however susceptible to a host of psychometric weaknesses.² While examiners are instructed to judge against a behavioural standard (global score) they tend to make judgements by comparing candidates against one another. This comparison may lead to assimilation or contrast effects where a candidates checklist score is biased towards or away from preceding performances.²

In this study we wished to assess the effect that following a star candidate or indeed following a candidate who in unsatisfactory in a station, has on the subsequent candidates checklist score within a high-stakes OSCE. One vital aspect of any assessment process is fairness.³ If a checklist score is biased based on who you follow in the OSCE then the process may be considered unfair.