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Med Teach. 2017 Sep 22:1-7. doi: 10.1080/0142159X.2017.1372565. [Epub ahead of print]

A collaborative comparison of objective structured clinical examination (OSCE) standard setting methods at Australian medical schools.

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a College of Medicine and Dentistry , James Cook University , Townsville , Australia.
b School of Medicine , Deakin University , Geelong , Australia.
c School of Medicine , University of Tasmania , Hobart , Australia.
d School of Medicine , University of Wollongong , Wollongong , Australia.
e School of Health Professions Education , Maastricht University , Maastricht , The Netherlands.



A key issue underpinning the usefulness of the OSCE assessment to medical education is standard setting, but the majority of standard-setting methods remain challenging for performance assessment because they produce varying passing marks. Several studies have compared standard-setting methods; however, most of these studies are limited by their experimental scope, or use data on examinee performance at a single OSCE station or from a single medical school. This collaborative study between 10 Australian medical schools investigated the effect of standard-setting methods on OSCE cut scores and failure rates.


This research used 5256 examinee scores from seven shared OSCE stations to calculate cut scores and failure rates using two different compromise standard-setting methods, namely the Borderline Regression and Cohen's methods.


The results of this study indicate that Cohen's method yields similar outcomes to the Borderline Regression method, particularly for large examinee cohort sizes. However, with lower examinee numbers on a station, the Borderline Regression method resulted in higher cut scores and larger difference margins in the failure rates.


Cohen's method yields similar outcomes as the Borderline Regression method and its application for benchmarking purposes and in resource-limited settings is justifiable, particularly with large examinee numbers.

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