---
title: "OSCE sources and further reading"
description: "The twenty papers this guide leans on hardest, what each one settles, and the wider reading families worth knowing if you run an OSCE."
canonical: https://studydrome.com/docs/osce/toolkit/sources-and-further-reading/
updated: 2026-10-10
---

# OSCE sources and further reading

The twenty papers this guide leans on hardest, what each one settles, and the wider reading families worth knowing if you run an OSCE.

Every claim in this guide names its source on the page that makes it. This page gathers the twenty that carry the most weight. A reading list, a tender annex or a quality report can cite them from one place. The list sits at the foot of the page.

Reading all twenty is a month of work. Reading three is an afternoon. Take AMEE Guide 81 Part II for the operations. Take AMEE Guide 49 for the quality metrics. Take the 2020 Ottawa Consensus as the standard for what a defensible exam must show.

## What each family is for

**The AMEE guides.** The numbers are the shorthand the field uses. Guide 81 comes in two parts. Part I covers what the format can assess. Part II is the manual for running one. Guide 49 holds the quality metrics and their thresholds. Guide 18 covers standard setting. Guide 42 and the older Guide 13 cover simulated patients and when to use them. Guide 68 explains generalizability theory in plain terms.

**The measurement papers.** Brannick's review shows what OSCE reliability looks like across published exams. Peng's 2025 meta-analysis is the current evidence on station number and station length. Cook's guide to Kane's framework turns validity into an argument you can write down.

**The scoring papers.** Norcini on setting standards is the reference the rest cite. Ilgen compares checklists with global rating scales. Homer and Russell explain the minimum-stations rule and what it costs. Homer's 2022 paper puts a size on examiner stringency. That one tends to surprise a committee.

**The operational papers.** Wagner on marking by screen is the strongest single case for it. Daniels and Pugh give the best short read on station development. Nyangeni's seven-step framework is the clearest account of starting from nothing.

**The candidate papers.** Sterz describes a written feedback model that works, and says what students still found missing. Pell's 2012 follow-up of weaker students is the uncomfortable one. It is why this guide is careful about remediation.

**The regulator documents.** National bodies publish their own OSCE specifications. They are worth reading even when they do not govern you. The main three are the Nursing and Midwifery Council test of competence, the Pharmacy Examining Board of Canada Part II exam, and the General Medical Council PLAB 2 guide. For schools in Georgia, the national quality agency review of medical education is the local baseline.

**The book.** Harden, Lilley and Patricio, *The Definitive Guide to the OSCE* (Elsevier, 2015). It is paid, it is not online, and it is still the only book on the subject. If your library buys one OSCE book, buy this one.

## What is not on the list

Three areas have thinner evidence than their tone suggests. This guide treats them with matching care. Cost models rest on a few old studies, so their figures do not transfer. Virtual and hybrid delivery has a growing literature that mostly describes. Drafting stations with language models have tip lists, not outcome studies. Where the guide covers those topics, it says what is known and what is not.

## Frequently asked questions

### Can we cite this guide in our quality report?

Cite the sources rather than the guide. A reviewer wants the primary reference behind a threshold, not a secondary description of it. Every page here names its sources at the foot, and this page collects the twenty used most often.

### Which of these are free to read?

Most are open access or have a free full text in PubMed Central, including the Wagner, Sterz, Nyangeni and Peng papers. The AMEE guides in Medical Teacher are usually behind a subscription, though many institutions hold one. The Harden book is paid.

### How current is this list?

It mixes foundational papers that will not date, such as Harden 1975 and Norcini 2003, with recent work from 2021 onward where the evidence has moved, particularly on examiner variability, station number and feedback. The guide is updated as new evidence lands.

### We only have time for one paper. Which one?

AMEE Guide 81 Part II. It is the operational backbone of a working OSCE, and most of what an exam office needs to decide in its first year is addressed somewhere in it.

**Sources**

1. [Harden RM, Stevenson M, Downie WW, Wilson GM. Assessment of clinical competence using objective structured examination](https://doi.org/10.1136/bmj.1.5955.447) (BMJ, 1975)
2. [Khan KZ, Ramachandran S, Gaunt K, Pushkar P. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part I: an historical and theoretical perspective](https://doi.org/10.3109/0142159X.2013.818634) (Medical Teacher, 2013)
3. [Khan KZ, Gaunt K, Ramachandran S, Pushkar P. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part II: organisation and administration](https://doi.org/10.3109/0142159X.2013.818635) (Medical Teacher, 2013)
4. [Pell G, Fuller R, Homer M, Roberts T. How to measure the quality of the OSCE: a review of metrics. AMEE Guide No. 49](https://doi.org/10.3109/0142159X.2010.507716) (Medical Teacher, 2010)
5. [Boursicot K, Kemp S, Wilkinson T, et al. Performance assessment: consensus statement and recommendations from the 2020 Ottawa Conference](https://doi.org/10.1080/0142159X.2020.1830052) (Medical Teacher, 2021)
6. [Cook DA, Brydges R, Ginsburg S, Hatala R. A contemporary approach to validity arguments: a practical guide to Kane's framework](https://doi.org/10.1111/medu.12678) (Medical Education, 2015)
7. [Brannick MT, Erol-Korkmaz HT, Prewett M. A systematic review of the reliability of objective structured clinical examination scores](https://doi.org/10.1111/j.1365-2923.2011.04075.x) (Medical Education, 2011)
8. [Peng J, et al. Impact of station number and duration time per station on the reliability of OSCE scores: a systematic review and meta-analysis](https://doi.org/10.1186/s12909-025-06691-0) (BMC Medical Education, 2025)
9. [Nyangeni T, ten Ham-Baloyi W, van Rooyen DRM. Strengthening the planning and design of objective structured clinical examinations](https://doi.org/10.4102/hsag.v29i0.2693) (Health SA Gesondheid, 2024)
10. [Daniels VJ, Pugh D. Twelve tips for developing an OSCE that measures what you want](https://doi.org/10.1080/0142159X.2017.1390214) (Medical Teacher, 2018)
11. [Ilgen JS, Ma IWY, Hatala R, Cook DA. A systematic review of validity evidence for checklists versus global rating scales in simulation-based assessment](https://doi.org/10.1111/medu.12621) (Medical Education, 2015)
12. [Lewis KL, Bohnert CA, Gammon WL, et al. The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP)](https://doi.org/10.1186/s41077-017-0043-4) (Advances in Simulation, 2017)
13. [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)
14. [Norcini JJ. Setting standards on educational tests](https://doi.org/10.1046/j.1365-2923.2003.01495.x) (Medical Education, 2003)
15. [Homer M, Russell J. Conjunctive standards in OSCEs: the why and the how of number of stations passed criteria](https://doi.org/10.1080/0142159X.2020.1856353) (Medical Teacher, 2021)
16. [Homer M. Pass/fail decisions and standards: the impact of differential examiner stringency on OSCE outcomes](https://doi.org/10.1007/s10459-022-10096-9) (Advances in Health Sciences Education, 2022)
17. [Pell G, Fuller R, Homer M, Roberts T. Advancing the objective structured clinical examination: sequential testing in theory and practice](https://doi.org/10.1111/medu.12136) (Medical Education, 2013)
18. [Pell G, Fuller R, Homer M, Roberts T. Is short-term remediation after OSCE failure sustained? A retrospective analysis of the longitudinal attainment of underperforming students in OSCE assessments](https://doi.org/10.3109/0142159X.2012.643262) (Medical Teacher, 2012)
19. [Sterz J, Linßen S, Stefanescu MC, et al. Implementation of written structured feedback into a surgical OSCE](https://doi.org/10.1186/s12909-021-02581-3) (BMC Medical Education, 2021)
20. [Macharashvili L, Bakakuri T, Shioshvili N, Munjishvili G. Medical Education in Georgia: Quality Assurance, Main Trends and Challenges. Thematic Analysis](https://eqe.ge/res/docs/2020/TA_NCEQE_MEDICINE_ENG_2021.pdf) (NCEQE and EU Twinning, Tbilisi, 2021)

> [!NOTE]
> **Using these in a review file**
> A quality review asks for the reference behind each threshold you apply, not a bibliography. Match each source to the decision it supports. The evidence for accreditors page in the quality section shows what that file looks like.