Organization of an objective structured clinical examination (OSCE): Steps prior to its realization

The Objective Structured Clinical Examination (OSCE) has become consolidated in Medicine as a key instrument to assess practical training in undergraduate studies. In Spain, following the standardization promoted by the CNDFME and the organizational experience during COVID-19, the current model combines a national virtual OSCE of 10 stations with a local in-person OSCE of 10 stations, balancing comparability across faculties with adaptation to each center’s resources. The main objective was to describe and systematize the current model, with emphasis on the 10-station in-person OSCE, detailing its planning, structure, and requirements for large cohorts. The study followed a descriptive process-based design grounded in organizational experience and operational protocols. The organization is structured into: i) early constitution of the committee (≥6 months in advance); ii) definition of the competency map; iii) planning through checklists covering stations, evaluators/actors, logistics, and students; iv) technical design of circuits, rounds, timing, and spatial distribution; and v) prior standardization instructions. Guidelines were established for station design, case development and rubrics, and evaluator and actor training. The results confirmed the dual scheme recognized by the CNDFME. The committee integrates academic authorities and clinical specialists, defining the schedule, resources, and quality control. Stations (with simulated patients, technical tasks, or “chair stations”) include an initial scenario and weighted rubrics assessing anamnesis, physical examination, technical skills, communication, clinical reasoning, prevention, professionalism, and interprofessional relations. For large cohorts, simultaneous rounds of 10×10 minutes with consecutive shifts are employed. It was concluded that the OSCE requires early planning, clear governance, and standardized controls; the dual scheme improves traceability, operational feasibility, and the validity of competence-based assessment.