The show must go on? Patients, props and pedagogy in the theatre of the OSCE

According to Shakespeare, all the world's a stage, and all the men and women merely players. The objective structured clinical examination (OSCE), that most ubiquitous form of assessment in health professions education, offers us a particular instance of this maxim. Comprising at first glance a world of psychometric data, detailed checklists and global rating scales, the OSCE sets out to facilitate the assessment of a candidate's competence in a highly standardised and objective fashion. Despite this clear intention, OSCEs also offer a rich vein of (often unacknowledged) social and cultural processes. In this commentary, we draw on Goffman's dramaturgy metaphor and our experiences to undertake a wry examination of some of the least intended consequences of OSCEs. We take a satirical look at both the potential impact on patients and the pedagogical implications of this form of assessment. We now urge you to sit back, settle in and enjoy the show, as we raise the curtain on this one-night-only performance!