Is short-term remediation after OSCE failure sustained? A retrospective analysis of the longitudinal attainment of underperforming students in OSCE assessments

Abstract

Background: Significant improvements in the delivery of criterion-based assessment techniques have improved confidence in standard setting and assessment quality. However, for underperforming students, a lack of evidence about longitudinal performance of this group poses dilemmas to educators when making decisions about the timing and nature of remediation.

Aim: To investigate the longitudinal performance of the UK undergraduate medical degree students, with a particular focus on comparing the poorly performing students (i.e. those with borderline or failing grades) with the main cohort of students.

Method: Over a 5-year period, 3200-student objective structured clinical examination (OSCE) assessments from a single medical school were investigated. A poorly performing subgroup of 125 students was identified and their longitudinal performance in the final 3 years of the undergraduate medical degree analysed.

Result: The relative performance of this student group declines across serial OSCEs, despite current methods of ‘remediation and retest’.

Conclusions: This analysis demonstrates that typically students in the poorly performing subgroup achieve only short-term success with traditional remediation and retest models, and critically show an absence of longitudinal improvement. There is a clear need for institutions to develop profiling models that can help identify this student group and develop effective, research led models of remediation.