Standard setting methods in objective structured clinical examination (OSCE) - A comparative study of five methods

Q: What is the purpose of standard-setting methods in OSCE?

Standard setting determines cut-off scores that separate competent from less competent students, directly affecting pass/fail outcomes.

Q: Which five OSCE standard-setting methods were compared in the study?

The study compared norm reference, Angoff method, borderline group method (BGM), borderline regression method (BRM), and modified Cohen’s method.

Q: How did different methods influence failure rates in the results?

Norm reference and BRM produced higher cut-off scores and more failures, while the Angoff method produced lower cut-off scores and fewer failed students.

Sep 20, 2026

Uploaded by Miles

Objective Structured Clinical Examination (OSCE) is a key medical school assessment for evaluating student competency, especially clinical skills across cognitive and affective domains. OSCE outcomes depend on standard-setting procedures, which can produce different cut-off scores and failure rates. This study compared five methods—norm reference, Angoff, borderline group (BGM), borderline regression (BRM), and modified Cohen’s—to determine cut-off scores and failure rates for OSCE stations.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background & Objective

Material & Methods

Results

Conclusion

Introduction

Mohamed Ansari et al. J Med Edu Dev. 2024; 17(56): 87-96 Journal of Medical Education Development Original Article Standard setting methods in objective structured clinical examination (OSCE): A comparative study of five methods Reshma Mohamed Ansari 1* , Norhafizah Ab Manan2 , Nur Ain Mahat3 , Norfaizatul Shalida Omar4 , Atikah Abdul Latiff5 , Sara Idris5 , Azli Shahril Othman6 1Medical Education Department International Medical School Management & Science University, Selangor Malaysia 2Department of Public Health Faculty of Medicine University of Cyberjaya, Selangor Malaysia 3Kulliyah of Nursing International Islamic University, Kuantan, Pahang, Malaysia. 4Department of Biochemistry Manipal University College Malaysia, Malacca Malaysia 5Department of Anatomy Faculty of Medicine University of Cyberjaya, Selangor Malaysia 6Department of Pharmacology Faculty of Medicine and Defence Health, National Defence University Malaysia, Kuala Lumpur Malaysia Article info Article history: Received 31 Jan. 2024 Accepted 20 Aug. 2024 Published 14 Dec. 2024 *Corresponding author: Reshma Mohamed Ansari, Medical Education Department International Medical School Management & Science University, Selangor, Malaysia. Email: [reshmaansari77@gmail.com](reshmaansari77@gmail.com) How to cite this article: Mohamed Ansari R, Ab MananN, Mahat NA, Shalida OmarN, Abdul LatiffA, Idris S, Shahril Othman A. Standard setting methods in objective structured clinical examination (OSCE): A comparative study of five methods. J Med Edu Dev. 2024; 17(55): 87-96. Abstract Background & Objective: Objective Structured Clinical Examination (OSCE) is a crucial component in medical school examinations to assess students’ competency, particularly in clinical skills incorporating cognitive and affective domains. OSCE results are subjected to standard-setting methods, which yield different findings. Hence, in this study, five different standard-setting methods, namely norm reference, Angoff method, borderline group method (BGM), borderline regression method (BRM), and modified Cohen’s method, were compared to determine the cut-off scores and failure rates determined by each method. Material & Methods: Data of 170 second-year medical students who attended OSCE with eight stations for their First Professional Examination at the end of year 2 MBBS was taken for the study following ethical approval. Total scores for each station were standardized to 20 marks, and cut-off scores were determined using each of the five standard-setting methods. Results: As a comparison of 5 methods, the Norm reference method yielded the highest number of stations with high cut-off scores, followed by BRM. This is reflected in the number of failures, too. On the contrary, using the Angoff method yielded the lowest cut-off scores in maximum stations, resulting in the least number of failed students. The Cochrane’s Q test of the results yielded a p < 0.001, which signifies that the proportion of students who failed a particular OSCE station was significantly different when different methods were used to determine the cut score. Conclusion: The study, which compared 5 common standard-setting methods employed in medical education assessments, found that norm-referenced and BRM had high cut-off scoresand failures, with the opposite determined by the Modified Angoff method. The study concluded that the cut-off score and failure rate differed with different standard-setting methods, and the choice of the method is contextual depending on the available resources. Keywords: standard setting, OSCE, Angoff, norm-reference, borderline group, borderline regression, Cohen Introduction Medical schools have continually emphasized the importance of Objective Structured Clinical Examinations (OSCEs) in assessments to ensure competency and patient safety (1) . Medical educationistshave named OSCE one of the most reliable, practical, and effective ways of assessing compet

FAQs

What is the purpose of standard-setting methods in OSCE?

Standard setting determines cut-off scores that separate competent from less competent students, directly affecting pass/fail outcomes.

Which five OSCE standard-setting methods were compared in the study?

The study compared norm reference, Angoff method, borderline group method (BGM), borderline regression method (BRM), and modified Cohen’s method.

How did different methods influence failure rates in the results?

Norm reference and BRM produced higher cut-off scores and more failures, while the Angoff method produced lower cut-off scores and fewer failed students.

Sep 20, 2026

Uploaded by Miles