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This quasi-experimental historical-control study compared a 2021 tele-OSCE with a 2019 in-person OSCE for 5th-year medical students, assessing scores and pass/fail decisions, acceptability, direct costs, examination time, and logistics, including psychometric agreement.",{"@graph":69,"@context":123},[70,84,106],{"@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/introducing-a-smartphone-tele-objective-structured-clinical-examination-to-support-high-stakes-competency-decisions-a-quasi-experimental-study-and-curricular-implications/447156/",{"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/introducing-a-smartphone-tele-objective-structured-clinical-examination-to-support-high-stakes-competency-decisions-a-quasi-experimental-study-and-curricular-implications/447156.png","ImageObject",300,407,{"name":92,"@type":93},"A glass of water","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",16,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What problem does the study address about high-stakes OSCEs?","Question",{"text":113,"@type":114},"High-stakes OSCEs are resource-intensive and may constrain access and equity, particularly for candidates from remote locations.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the smartphone tele-OSCE evaluated?",{"text":118,"@type":114},"The study used a quasi-experimental historical-control design comparing a 2021 tele-OSCE with a 2019 in-person OSCE, measuring overall scores, pass/fail decisions, acceptability, costs, total time, and logistics, along with psychometric checks.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key findings regarding assessment performance and logistics?",{"text":122,"@type":114},"Tele-OSCE mean scores were lower than the in-person OSCE, while pass rates remained similarly high; interexaminer agreement was moderate to high. 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Smartphone-based tele-OSCEs could reduce logistical burdens while maintaining assessment quality.  \nObjective: To evaluate whether a smartphone tele-OSCE yields assessment outcomes comparable to an in-person OSCE while improving implementation efficiency, costs, and acceptability within an undergraduate medical curriculum. Methods: We conducted a quasi-experimental historical-control study (2021 tele-OSCE vs 2019 in-person OSCE) in 5thyear medical students at a single university in China. The tele-OSCE comprised 2 stations (history taking, clinical reasoning) aligned with the course blueprint. Primary outcomes included overall scores and pass/fail decisions; secondary outcomes included examiner/standardized patient (SP)/student acceptability, direct per-candidate costs, total examination time, and logistical metrics. Psychometric analyses included interexaminer correlations and descriptive consistency checks.  \nResults: Of 176 candidates scheduled for the 2021 tele-OSCE, 164 without prior online-OSCE exposure were analyzed;  \n272 in-person candidates from 2019 served as historical controls. Students in the tele-OSCE cohort obtained lower mean scores than those in the 2019 in-person OSCE cohort (65.6 ± 11.2 vs 72.0 ± 10.6; P \u003C .001; Cohen’s d = 0.59), although pass rates remained similarly high in both years. Interexaminer correlations across 4 cases ranged from r = .47 to .93 (all P \u003C .05), indicating moderate-to-high agreement. Direct costs per candidate were modestly higher for tele-OSCE than in-person (USD45.22 vs 40.13; + 12.7%). The tele-OSCE eliminated the need for candidates to travel (commuting) and reduced on-site density; most students, SPs, and examiners reported positive acceptability.  \nConclusions: A smartphone tele-OSCE can support curriculum-integrated, high-stakes competency decisions with performance outcomes that remain within an acceptable range relative to the conventional format, while improving logistical feasibility. We provide implementation details and practical guidance to facilitate replication in similar curricular settings.  \nKeywords  \ntele-OSCE, smartphone-based assessment, high-stakes examinations, objective structured clinical examination, curricular implementation  \nReceived: 30 September 2025; accepted: 16 December 2025  \n1 Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China  \n2Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China  \n3Department of Plastic and Burn Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China  \n4The First School of Clinical Medicine, Nanjing Medical University, Nanjing, China  \n5Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China  \n6Department of Geriatric Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China  \n7Department of Gynecology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China  \n8Guangdong Academy for","cbCaikwFawnjkoy0","https://ap.wps.com/l/cbCaikwFawnjkoy0","pdf",4207750,14,"English","# Background\n# Objective\n# Methods\n## Study design\n## Outcomes and psychometric analyses\n# Results\n## Assessment outcomes and pass/fail\n## Costs, time, and logistics\n## Acceptability\n# Conclusions\n# Implementation implications","[{\"question\":\"What problem does the study address about high-stakes OSCEs?\",\"answer\":\"High-stakes OSCEs are resource-intensive and may constrain access and equity, particularly for candidates from remote locations.\"},{\"question\":\"How was the smartphone tele-OSCE evaluated?\",\"answer\":\"The study used a quasi-experimental historical-control design comparing a 2021 tele-OSCE with a 2019 in-person OSCE, measuring overall scores, pass/fail decisions, acceptability, costs, total time, and logistics, along with psychometric checks.\"},{\"question\":\"What were the key findings regarding assessment performance and logistics?\",\"answer\":\"Tele-OSCE mean scores were lower than the in-person OSCE, while pass rates remained similarly high; interexaminer agreement was moderate to high. Tele-OSCE reduced the need for candidate travel, lowered on-site density, and improved implementation feasibility and acceptability.\"}]","Introducing a Smartphone Tele-Objective Structured Clinical Examination to Support High-Stakes Competency Decisions - A Quasi-Experimental Study and Curricular Implications | PDF",1790719043,35]