Remediating students' failed OSCE performances at one school: the effects of self-assessment, reflection, and feedback

Acad Med. 2009 May;84(5):651-4. doi: 10.1097/ACM.0b013e31819fb9de.


Purpose: To investigate whether and how use of an online remediation system requiring reflective review of performance and self-assessment influenced students' performance on objective structured clinical examination (OSCE) station repeats (subsequent to failure on the first attempt) and their self-assessments of their performance (between the first and second attempts).

Method: Fourth-year medical students' performances on seven OSCE stations were videotaped at University of Michigan Medical School in 2006. Failing students took the exam again; remediation included self-assessment and review, plus faculty guidance for failures that were greater than one standard error of measurement of the distribution. A total of 1,171 possible observations of students' actual performance and performance self-assessments were analyzed using independent and dependent t tests and within-subjects ANOVA.

Results: Results indicate statistically significant changes in students' performance between first and second attempts and statistically significant improvements in self-assessment between first and second attempts. No significant changes were found between self-assessed and faculty-guided remediation.

Conclusions: This study provides evidence that OSCE remediation combining review, reflection, and self-assessment has a salutary effect on (subsequent) performance and self-assessment of performance.

Publication types

  • Evaluation Study

MeSH terms

  • Clinical Competence*
  • Education, Medical, Undergraduate*
  • Educational Measurement
  • Humans
  • Internet
  • Remedial Teaching / methods*
  • Self-Assessment