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Traditional double scoring (DS) improves reliability but is labor-intensive and expensive, especially for large cohorts. This study proposes Targeted Double Scoring (TDS), selectively applying DS to critical score ranges near the pass/fail threshold. Using pilot remote OSCE data from 550 undergraduates across three stations, TDS reduces rater workload and costs while preserving high reliability and fairness, achieving up to 70% cost savings in some configurations.",{"@graph":69,"@context":114},[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":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/optimizing-cost-effectiveness-in-remote-objective-structured-clinical-examinations-through-targeted-double-scoring-methodologies/317314/",{"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/optimizing-cost-effectiveness-in-remote-objective-structured-clinical-examinations-through-targeted-double-scoring-methodologies/317314.png","ImageObject",300,407,{"name":92,"@type":93},"Mimi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108],{"name":109,"@type":110,"acceptedAnswer":111},"What outcomes does the study report for TDS?","Question",{"text":112,"@type":113},"TDS significantly reduces rater workload and costs while maintaining high reliability and fairness, with up to 70% cost savings under certain configurations.","Answer","https://schema.org",{"og:url":83,"og:type":116,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":118,"canonical":83},"index,follow",{"doc_id":120,"site_id":62},317314,1790109428,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":92,"user_avatar":125,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":131,"language":132,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":133,"faqs":134,"seo_title":135,"seo_description":67,"update_tm":136,"read_time":41,"preview_page_count":4},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","UC Merced  \nUC Merced Previously Published Works  \nTitle  \nOptimizing cost-effectiveness in remote objective structured clinical examinations through targeted double scoring methodologies  \nPermalink  \n[https://escholarship.org/uc/item/8d81j4n5](https://escholarship.org/uc/item/8d81j4n5)  \nJournal  \nMedical Education Online, 30(1)  \nISSN  \n1087-2981  \nAuthors  \nFu, Zhihui  \nWu, Yuhong Xu, Linglinget al.  \nPublication Date  \n2025-12-31  \nDOI  \n10.1080/10872981.2025.2467477  \nCopyright Information  \nThis work is made available under the terms of a Creative Commons AttributionNonCommercial License, available at [https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)  \nPeer reviewed  \n[eScholarship.org](eScholarship.org) Powered by the California Digital Library  \nUniversity of California  \nRAPID COMMUNICATION  \nOptimizing cost-effectiveness in remote objective structured clinical examinations through targeted double scoring methodologies  \nZhihui Fu a,b, Yuhong Wu a,b, Lingling Xu c,d, Fen Cai c,d, Ren Liu e and Zhehan Jiang c,d  \na Department of Statistics, School of Mathematics and Statistics, Minnan Normal University, Zhangzhou, Fujian, China; bFujian Key Laboratory of Granular Computing and Applications, Minnan Normal University, Zhangzhou, Fujian, China; cInstitute of Medical Education, Peking University, Beijing, China; dPeking University Health Science Center-Chaoxing Joint Laboratory for Digital and Smart Medical Education, Beijing, China; ePsychological Science, University of California, Merced, CA, USA  \nABSTRACT  \nThe remote Objective Structured Clinical Examination (OSCE) is a cornerstone of medical education, enabling structured and objective assessment of clinical skills, communication, and patientcentered care. However, its widespread adoption has introduced challenges related to costeffectiveness and efficient use of rater resources. Traditional double scoring (DS) ensures reliability but is labor-intensive and costly, especially in large-scale assessments. To address these challenges, this study introduces Targeted Double Scoring (TDS), a novel methodology that selectively applies DS to specific score ranges, particularly those near the pass/fail threshold. The study was conducted using data from a pilot remote OSCE administered to 550 clinical medicine undergraduates in China. The OSCE consisted of three stations: Clinical Reasoning (CR), Physical Examination (PE), and Fundamental Skills (FS). Each station was scored remotely by two raters, with a cut-off score of 60 out of 100. The TDS methodology was modeled based on the OSCE’s DS design and fitted with scoring data. A decision-theoretic approach identified optimal Critical Score Ranges (CSRs) for targeted double scoring, balancing reliability and cost-effectiveness. The findings show that TDS significantly reduces rater workload and costs while maintaining high reliability and fairness. For instance, TDS achieved up to 70% cost savings compared to traditional DS under certain configurations. The study also highlights the flexibility of TDS, which can be tailored to different OSCE designs and scoring rubrics. These results have broad implications for medical education, especially in resource-constrained settings where optimizing assessment efficiency is critical. This study provides a practical solution to the cost-related challenges of remote OSCEs and offers a framework for adopting TDS in assessments. By focusing raters on critical score ranges, TDS maintains rigorous and fair evaluations without overburdening faculty or exceeding budgets. Future research should explore TDS scalability and its integration with emerging technologies like artificial intelligence to enhance efficiency and reliability.  \nARTICLE HISTORY  \nReceived 7 December 2023 Revised 21 January 2025 Accepted 11 February 2025  \nKEYWORDS  \nOSCE; remote scoring; targeted double scoring; cost-saving strategy; digital assessment  \nIntroduction  \nThe imp","cbCaisrO75rFdjrk","https://ap.wps.com/l/cbCaisrO75rFdjrk","pdf",5937238,12,"English","# Introduction\n## Traditional scoring and remote OSCE challenges\n## Targeted Double Scoring (TDS) approach\n# Methods and pilot study design\n## OSCE stations and scoring setup\n## Critical Score Ranges and decision-theoretic modeling\n# Results and implications","[{\"question\":\"What outcomes does the study report for TDS?\",\"answer\":\"TDS significantly reduces rater workload and costs while maintaining high reliability and fairness, with up to 70% cost savings under certain configurations.\"}]","Optimizing cost-effectiveness in remote objective structured clinical examinations through targeted double scoring methodologies | PDF",1789931570]