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The approach uses a preliminary screening test with fewer stations, then a supplemental test for those who do not meet passing criteria. Emphasis is placed on ensuring the first-test results accurately predict main-test performance through blueprinting, careful station selection, and minimizing false positives and false negatives to protect patient safety and optimize resource use.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-reflection-on-sequential-osce-in-medical-education/317238/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-reflection-on-sequential-osce-in-medical-education/317238.png","ImageObject",300,407,{"name":92,"@type":93},"Sage","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-24","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does Sequential OSCE aim to solve in medical education?","Question",{"text":112,"@type":113},"It addresses the high implementation cost of standard OSCEs by reducing the number of stations, which lowers the needs for patients, standardized patients, and examiners.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does Sequential OSCE determine a student's final status?",{"text":117,"@type":113},"Students first take a screening test with fewer stations. Those who do not pass enter a supplemental test, and their total performance across both tests determines their final outcome.",{"name":119,"@type":110,"acceptedAnswer":120},"Why is minimizing false positives important in a screening OSCE?",{"text":121,"@type":113},"False positives can incorrectly accept an incompetent student, creating a serious threat to patient safety because OSCE is designed to assess clinical competence.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},317238,1790117015,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52},687197207057,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","A Reflection on Sequential OSCE in Medical Education  \n*Zahra Abdolreza Gharehbagh1, 2 11  \n1Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran. 2Faculty Member, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.  \nDear Editor-in-chief  \nPractical exams are frequently used in the training and evaluation of medical students. One such exam is the Objective Structured Clinical Examination (OSCE) . The OSCE exam is organized objectively in different stations, and examinees are asked to perform specific clinical tasks at each station (1) . One limitation of the OSCE exam is its high implementation cost (2) . Increasing the number of OSCE stations reduces measurement error and enhances test reliability (3) . Conversely, reducing station numbers can help save resources like examiners, patients, or standardized patients (SPs) (4) . The sequential OSCE method has been proposed to address cost challenges while maintaining high reliability (5) . In this approach, students first participate in a preliminary test with fewer stations. For instance, if the main test typically involves 20 stations, the initial test might include only 10 or fewer stations. By reducing the number of stations, patients, SPs, and examiners, the sequential OSCE method significantly lowers examination costs. Students who do not pass the initial test will participate in a supplemental test, with their total performance across both tests determining their final status (3, 4), equivalent to participating in a single comprehensive exam. Students who successfully pass the initial exam are exempted from the subsequent test, with only their first exam performance being considered (4) .  \nIn sequential assessment, the results of the first test should accurately predict students' performance in the main test, effectively screening capable learners. Achieving this requires careful consideration of several key points: designing the entire test's blueprint first and then strategically selecting stations for the initial screening test. The screening test must be conceptualized within the comprehensive test's framework and context. Understanding the typical failure rate is crucial, as most similar examinations expect only a small number of students to fail. The screening test should be meticulously designed to minimize both false negatives and false positives (6) . False positives occur when students pass the screening exam but are ultimately rejected in the total exam, indicating potential decision-making errors and low test specificity. Since OSCE assesses clinical competence, incorrectly accepting an incompetent student poses a serious threat to patient safety. False negatives represent students who initially fail the test but demonstrate acceptable performance across both tests and are ultimately passed. The number of negative cases is critical: a small number suggests an economical second test, while a large number undermines the primary goal of resource conservation. Ideally, both false positives and false negatives should be minimized, with a particular emphasis on maintaining low false positive rates in the screening test (6, 7) .  \nKey Words: Cost, Objective Structured Clinical Examination, Sequential, Medical Education.  \n*Please cite this article as: Abdolreza Gharehbagh Z. A Reflection on Sequential OSCE in Medical Education. Med Edu Bull 2023; 4(4): 834-37. DOI: 10.22034/MEB.2024.434280.1089  \n*Corresponding Author:  \nZahra Abdolreza Gharehbagh, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran.  \n[Email: Zgharebagh@iautmu.ac.ir](Email: Zgharebagh@iautmu.ac.ir)  \nReceived date: Jul. 25, 2023; Accepted date: Dec. 12, 2023  \nA review article about implementing OSCE through sequential assessment suggests that student rejection and acceptance rates in the screening test can be determined by calculating the passing rate usin","cbCaigI9kiKIpKCX","https://ap.wps.com/l/cbCaigI9kiKIpKCX","pdf",260872,"English","# Introduction\n## Principles and cost trade-offs\n# Decision accuracy in sequential assessment\n## False positives and false negatives\n## Screening blueprint and station selection\n# Evidence and supporting studies\n## Retrospective and empirical findings","[{\"question\":\"What problem does Sequential OSCE aim to solve in medical education?\",\"answer\":\"It addresses the high implementation cost of standard OSCEs by reducing the number of stations, which lowers the needs for patients, standardized patients, and examiners.\"},{\"question\":\"How does Sequential OSCE determine a student's final status?\",\"answer\":\"Students first take a screening test with fewer stations. Those who do not pass enter a supplemental test, and their total performance across both tests determines their final outcome.\"},{\"question\":\"Why is minimizing false positives important in a screening OSCE?\",\"answer\":\"False positives can incorrectly accept an incompetent student, creating a serious threat to patient safety because OSCE is designed to assess clinical competence.\"}]","A Reflection on Sequential OSCE in Medical Education | PDF",1789930451]