Should we video OSCEs for student appeals?

Abstract

Those setting objective structured clinical exams (OSCEs) are likely to encounter candidates who dispute the examiners' scores and feedback. At our own institution, candidates have requested video recording to aid in later academic appeals. Before ceding to such requests, we wished to be certain that the marking of recorded OSCEs would give comparable results to live marking, and that technical challenges could be met within reasonable cost. We adopted a mixed-methods approach to explore the use of video recording OSCEs. Following an initial literature review, we surveyed and interviewed the assessment leads of UK medical schools and postgraduate institutions setting high stakes OSCEs to explore their views and experience in using recordings as part of summative OSCE assessments. Results from our literature review reveal inconsistent findings about the comparability of marks awarded from video marking and those awarded by examiner in-station marking, with suggestions that video marking generates lower scores. The majority of UK medical education institutions were neither videoing OSCEs nor considering doing so. Many logistical and assessor-related drawbacks to video review were identified, with significant concerns raised about how such a process could be feasibly managed. Although the videoing of OSCEs may superficially appear an easy solution to provide defensibility of the process, the potential use is beset with challenge, going beyond purely logistical and technical difficulties. The use of videoing for the purpose of OSCE appeals is not currently supported by the literature, nor by the majority of UK undergraduate and postgraduate medical education institutions delivering high-stakes summative OSCEs.