Indian Pediatrics

, Volume 56, Issue 9, pp 745–748 | Cite as

Effect of a Formative Objective Structured Clinical Examination on the Clinical Performance of Undergraduate Medical Students in a Summative Examination: A Randomized Controlled Trial

  • Nazdar Ezzaddin AlkhateebEmail author
  • Ali Al-Dabbagh
  • Mohammed Ibrahim
  • Namir Ghanim Al-Tawil
Research Paper



To study the effect of formative Objective structured clinical examination (OSCE) on the undergraduate medical students’ performance in a subsequent summative-OSCE assessment.


In a randomized single-blind trial, 130 fifth year medical students at Raparin hospital, Erbil were assigned to intervention (n=61) and control group (n=69). Formative-OSCE was performed for the intervention group in pediatric module with feedback on their performance versus standard pediatric module for the control group. Students’ clinical performance was assessed by a summative-OSCE. Multiple regression was used to predict the summative-OSCE score depending on the participation in formative-OSCE along with the other factors.


Eleven students were excluded because of early drop-out, leaving 119 students for analysis. The summative-OSCE mean score (out of a total score of 100) in intervention group 64.6 (10.91) was significantly lower as compared to the control group 69.2 (10.45).


Single formative-OSCE does not necessarily lead to better performance in subsequent summative-OSCE.


Assessment Clinical competence Educational measurement Medical Eduation 


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Funding: Hawler Medical University. No contribution to data design, collection, analysis or interpretation was made by the funding resource.


  1. 1.
    Carrillo-de-la-Peña MT, Baillès E, Caseras X, Martínez À, Ortet G, Pérez J. Formative assessment and academic achievement in pre-graduate students of health sciences. Adv Heal Sci Educ. 2009;14:61–7.CrossRefGoogle Scholar
  2. 2.
    Siddiqui ZS. Framework for an effective assessment: From rocky roads to silk route. Pakistan J Med Sci. 2017;33:505–9.Google Scholar
  3. 3.
    Tridane M, Belaaouad S, Benmokhtar S, Gourja B, Radid M. The impact of formative assessment on the learning process and the unreliability of the mark for the summative evaluation. Procedia -Social Behav Sci. 2015;197:680–5.CrossRefGoogle Scholar
  4. 4.
    Pugh D, Desjardins I, Eva K. How do formative objective structured clinical examinations drive learning? Analysis of residents’ perceptions. Med Teach. 2018;40:45–52.CrossRefGoogle Scholar
  5. 5.
    Konopasek L, Norcini J, Krupat E. Focusing on the formative: Building an assessment system aimed at student growth and development. Acad Med. 2016;91:1492–7.CrossRefGoogle Scholar
  6. 6.
    Chisnall B, Vince T, Hall S, Tribe R. Evaluation of outcomes of a formative objective structured clinical examination for second-year UK medical students. Int J Med Educ. 2015;6:76–83.CrossRefGoogle Scholar
  7. 7.
    Sobh AH, Austin Z, Izham MIM, Diab MI, Wilby KJ. Application of a systematic approach to evaluating psychometric properties of a cumulative exit-from-degree objective structured clinical examination (OSCE). Curr Pharm Teach Learn. 2017;9:1091–8.CrossRefGoogle Scholar
  8. 8.
    Gupta P, Dewan P, Singh T. Objective structured clinical examination (OSCE) revisited. Indian Pediatr. 2010;47:911–20.CrossRefGoogle Scholar
  9. 9.
    Townsend AH, Mcllvenny S, Miller CJ, Dunn E V. The use of an objective structured clinical examination (OSCE) for formative and summative assessment in a general practice clinical attachment and its relationship to final medical school examination performance. Med Educ. 2001;35:841–6.CrossRefGoogle Scholar
  10. 10.
    Furmedge DS, Smith L-J, Sturrock A. Developing doctors: What are the attitudes and perceptions of year 1 and 2 medical students towards a new integrated formative objective structured clinical examination? BMC Med Educ. 2016;16:32.CrossRefGoogle Scholar
  11. 11.
    Farahat E, Javaherian-Dysinger H, Rice G, Schneider L, Daher N, Heine N. Exploring students’ perceptions of the educational value of formative objective structured clinical examination (OSCE) in a nutrition program. J Allied Health. 2016;45:20–6.PubMedGoogle Scholar
  12. 12.
    Jain V, Agrawal V, Biswas S. Formative assessment as an educational tool. J Ayub Med C Abbottabad. 2012;24:68–70.Google Scholar
  13. 13.
    Bernard AW, Ceccolini G, Feinn R, Rockfeld J, Rosenberg I, Thomas L, et al. Medical students review of formative OSCE scores, checklists, and videos improves with student-faculty debriefing meetings. Med Educ Online. 2017;22:1324718CrossRefGoogle Scholar
  14. 14.
    Gums TH, Kleppinger EL, Urick BY. Outcomes of individualized formative assessments in a pharmacy skills laboratory. Am J Pharm Educ. 2014;78:166.CrossRefGoogle Scholar
  15. 15.
    Lien H-H, Hsu S-F, Chen S-C, Yeh J-H. Can teaching hospitals use serial formative OSCEs to improve student performance? BMC Res Notes. 2016;9:464.CrossRefGoogle Scholar
  16. 16.
    Radford BW. The effect of formative assessments on teaching and learning [Master]. Brigham Young University. 2010. Available from: Accessed January 10, 2019.
  17. 17.
    Lipnevich AA, Smith JK. Response to assessment feedback: The effects of grades, praise, and source of information. ETS Research Report Series. 2008;1:i–57.CrossRefGoogle Scholar
  18. 18.
    Kluger AN, Denisi A. The effects of feedback interventions on performance: A historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychol Bull. 1996;9:254–84.CrossRefGoogle Scholar
  19. 19.
    Butler R. Enhancing and undermining intrinsic motivation: The effects of task involving and ego involving evaluation on interest and performance. Br J Educ Psychol. 1988;58:1–14.CrossRefGoogle Scholar
  20. 20.

Copyright information

© Indian Academy of Pediatrics 2019

Authors and Affiliations

  • Nazdar Ezzaddin Alkhateeb
    • 1
    Email author
  • Ali Al-Dabbagh
    • 2
  • Mohammed Ibrahim
    • 3
  • Namir Ghanim Al-Tawil
    • 4
  1. 1.Department of Pediatrics, College of MedicineHawler Medical UniversityErbil, Kurdistan regionIraq
  2. 2.Department of Surgery, College of MedicineHawler Medicine UniversityErbil, Kurdistan regionIraq
  3. 3.Department of Community Medicine, College of MedicineHawler Medicine UniversityErbil, Kurdistan regionIraq
  4. 4.Clinical TrainingQueensland Health ServiceQueenslandAustralia

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