Perspectives of advanced practitioner students on reliability and validity of objective structured clinical examinations

Background: The objective structured clinical examination (OSCE) is a key method of assessing clinical competency in advanced practitioner education in the UK. Despite its widespread use, research exploring the perceptions of reliability and validity of the OSCE among student advanced practitioners is limited. Methods: A mixed-methods exploratory survey was distributed nationally to student advanced practitioners who had completed an OSCE assessment. Quantitative data were analysed using descriptive statistics, while qualitative data underwent inductive thematic analysis. Results: Students generally perceive the OSCE as an appropriate assessment approach that provides valuable opportunities to demonstrate clinical skills. However, issues such as examination-related anxiety, variation in structure and assessor roles as well as limited realism of scenarios were identified. Preparation through formative OSCE, access to skills laboratories and peer support were critical to student confidence. Ethical concerns surrounding video recording without explicit consent were also raised. Conclusion: OSCEs remain a vital assessment tool in advanced practice education, yet improvements are needed to enhance realism, standardise structure, ensure ethical practice and better support students. Further research is recommended to examine the impact of formative OSCEs and alternative assessment models on student development. This article is the second of three; the first considered educators’ views of using OSCEs and the third is to consolidate and provide an in-depth discussion of findings.