--- title: "Paper versus electronic marking: what the licensing-exam data show" description: "The evidence on paper versus electronic OSCE marking: missed ratings, examiner preference, feedback quantity and quality, and the fallback plan." canonical: https://studydrome.com/docs/osce/delivery/paper-vs-electronic-marking/ updated: 2026-10-09 --- # Paper versus electronic marking: what the licensing-exam data show The evidence on paper versus electronic OSCE marking: missed ratings, examiner preference, feedback quantity and quality, and the fallback plan. The largest study of the question comes from the Swiss Federal Licensing Exam. Across 377 examiners at five faculties, 14.2 percent of paper checklists had at least one missed rating. On screen, where every item had to be filled, the figure was zero. Examiners also preferred the screen, and the preference grew with use. The evidence is about complete sheets and written feedback. Judgment stays with the examiner either way. ## What did the licensing-exam study find? Wagner and colleagues compared paper and on-screen checklists across two sittings of the Swiss licensing OSCE in 2014 and 2015. The table gives the findings that matter to an organizer. | Finding | Paper | On screen | | --- | --- | --- | | Checklists with at least one missed rating | 14.2% of 1,428 | None; every item was required before the next candidate | | Ease of use, rated by examiners | Lower on every item but one | Higher on every item except the speed of writing comments | | Examiners who preferred the screen, 2014 | | 54.5% | | Examiners who preferred the screen, 2015 | | 89.8% | The missed-rating figure is the one to remember. One paper sheet in seven came back with a gap. A gap is a score that has to be chased, guessed or dropped. Each of those choices weakens the station's data. The screen did not make examiners more careful. It made a sheet with a gap impossible to hand in. ## Why does paper lose ratings? Three reasons, and none of them is carelessness. A station runs on a bell. An examiner watching a candidate perform looks at the candidate, not at the sheet. They come back to an item that has already passed. A paper sheet has no way to say that an item is empty. And a sheet handed in at the end of a session is out of the examiner's hands before anyone reads it. The cross-check happens hours later, with the examiner gone. A screen changes the third point most. The count of scored candidates per station is visible while the session runs. The [run-sheet](/docs/osce/delivery/exam-day-operations-checklist/) still counts at every changeover. The count is a screen instead of a pile. ## What happens to written feedback? Two smaller studies looked at the comments examiners write. At one UK school, first-year OSCEs moved from paper to tablets. The share of examiner-candidate encounters with a comment rose from 41 to 51 percent. For candidates judged borderline, the rise was 22 points. A tested tool also rated the comments as higher quality. The authors' conclusion is in their title: feedback matters, and the device changed how much of it there was. At Heidelberg, examiners used tablets across two internal medicine OSCEs. They rated the effort as "hardly difficult". They named ease of use and a low error rate as the gains. Students who were interviewed accepted the format. Neither study is large. With the licensing exam data, they point in the same direction. The device is not the risk that examiners fear before the first sitting. ## What does a screen not change? The examiner's judgment. A screen enforces a complete sheet, not a correct one. A strict examiner is still strict on a tablet. The [examiner variance page](/docs/osce/people/examiner-variance/) covers what an organizer can do about that. The marking scheme is still the one the [design section](/docs/osce/design/designing-the-marking-scheme/) built. And the [briefing](/docs/osce/people/exam-day-briefings/) is still needed, with ten minutes added for the device the first time. Comment speed is the one item where paper won. Examiners who write long feedback type more slowly than they write. A school that wants long written feedback plans the slot for it. Or it accepts shorter comments on more candidates, which is what the UK study found. ## What must the plan cover either way? Paper needs a count-out and a count-in at every station. It needs a cross-check before the examiners leave. It needs a typing-up step with its own error rate. A screen needs devices charged and tested, a network the venue has measured, and a fallback. The [contingency page](/docs/osce/delivery/incidents-and-contingencies/) sets out the fallback. A paper pack sits sealed at every station. It is opened only when the floor manager says so. Its scores are checked against the record afterward. The cost comparison belongs to the [budget page](/docs/osce/planning/budget-and-cost-model/). The short version: paper is cheap on the day and costly afterward, in typing up, chasing, and appeals. A screen moves the cost to the day before. ## Frequently asked questions ### How many OSCE mark sheets are incomplete on paper? In the Swiss licensing exam, 14.2 percent of 1,428 paper sheets had at least one missed rating. On-screen sheets that required every item had none. ### Do examiners prefer electronic OSCE marking? In the Swiss study, 54.5 percent preferred it in the first year and 89.8 percent in the second. They rated it higher on every ease-of-use item except the speed of writing comments. ### Does electronic marking improve OSCE feedback? One UK school found comments in 51 percent of tablet encounters, compared with 41 percent on paper. For borderline candidates, the rise was 22 points. Comment quality was rated higher too. ### Does electronic marking make examiners more accurate? No. It makes a sheet with a gap impossible to hand in. Strict and lenient examiners stay that way. Training and monitoring deal with those. ### What is the fallback if devices fail on OSCE day? A sealed paper pack at every station, opened on the floor manager's word. Scores on paper are typed in afterward and checked against the record. Test the network before the day, not on it. ## Sources **Sources** 1. [Wagner FL, Feller S, Schmitz FM, et al. Usability and preference of electronic vs. paper and pencil OSCE checklists by examiners and influence of checklist type on missed ratings in the Swiss Federal Licensing Exam](https://doi.org/10.3205/zma001545) (GMS Journal for Medical Education, 2022) 2. [Denison A, Bate E, Thompson J. Tablet versus paper marking in assessment: feedback matters](https://doi.org/10.1007/s40037-016-0262-8) (Perspectives on Medical Education, 2016) 3. [Hochlehnert A, Schultz JH, Möltner A, et al. Electronic acquisition of OSCE performance using tablets](https://doi.org/10.3205/zma000983) (GMS Zeitschrift für Medizinische Ausbildung, 2015) > [!TIP] > **In practice** > The zero-missed-ratings result depends on a screen that refuses a sheet with a gap and a manager who can see each station's progress. To see how StudyDrome does both on exam day, read /docs/osce/delivery/in-studydrome-exam-day/.