Preprint
Remote Objective Structured Clinical Examinations (ROSCE) in health professions education: a meta-aggregate review of academic perspectives and recommendations
Educational Research Review
Elsevier
06/02/2026
Appears in Recent Faculty of Health Publications
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Abstract
Objective: Scoping advantages, disadvantages and future recommendations to implementation of Remote Objective Structured Clinical Examination (OSCE) versus in person OSCE in health profession education.
Background: Objective Structured Clinical Examination (OSCE) has been used extensively in education for health professionals. The COVID-19 epidemic resulted in traditional OSCE assessments being inconvenient. Alternative methods were sought to certify and evaluate health professionals to satisfy educational requirements and meet the urgent need for medical professionals. In this era of AI generated contamination in student work there is an urgent need for clinicians to address the healthcare demand and, one such remedy is Remote OSCE (ROSCE). ROSCE is a video/teleconference-based adaptation of the conventional in-person OSCE using digital platforms. Globally, rural and remote areas where clinical education needs are under met and demand for health care professionals is traditionally higher, ROSCE is anticipated to be one of the most reliable methods. This paper reviews the evidence on the advantages and disadvantages of ROSCE compared with traditional OSCE and provides recommendations for future research and implementation to optimise remote clinical assessments. It is intended that the results from this review will inform future education and assessment practices.
Methods The Enhancing Transparency in Reporting Synthesis of Qualitative Research statement and the Preferred Reporting Items for Systematic Reviews and JBI Meta-aggregate review was used in this qualitative review. Studies published from 2014 to 2025, written in English on remote OSCE in evaluating clinical competencies in health profession. Qualitative studies included to understand health academic's perspective. Studies that do not include health professions and clinical skills assessment were excluded from the review. Data was extracted by two independent reviewers, analysed by other members of the review team and appraised using the CASP.
Results: A total of 2779 studies were screened, 225 title and abstracts included after removing duplicates and first screen by two independent reviewers. 100 studies were included after full text review. This paper forms the reporting on 18 qualitative studies chosen for meta-aggregation after quality appraisal using critical appraisal tools. Eight overarching enabling themes were identified in this review for remote OSCE adoption including: 1. economic benefits, 2. standardisation of integrity and security, 3. automation and randomisation prospects, 4. real time feedback, 5.data analytics to pinpoint learning opportunities, 6. reduced carbon print,7. performance trends 8. Reduced staff workload. Barriers and disadvantages were also identified in the included studies and are reported in five themes: 1. technical failure, 2. lack of technology or virtual platforms, 3. significant staff training, 4. invasive proctoring tools, 5. false positives. Utilising the meta-aggregate qualitative thematic analysis, we provide a step-by-step recommendation for implementation from this review
Conclusion- Academics and education providers report ROSCE as an effective method of clinical, feasible and acceptable when well facilitated with robust technology, meeting academic integrity standards, and manageable for staff training and contingency planning. Geographically dispersed programmes benefitted from these alternative assessments as ROSCEs can serve as effective alternatives to in-person OSCEs, particularly for communication-intensive stations, distributed programs, and settings seeking cost, access, and environmental gains.
Details
- Title
- Remote Objective Structured Clinical Examinations (ROSCE) in health professions education: a meta-aggregate review of academic perspectives and recommendations
- Creators
- Hancy Issac - Southern Cross UniversityTaneal Wiseman - The University of SydneyGerben Keijzers - Gold Coast University HospitalBorkwei Ed Nignpense - Southern Cross UniversityClint Moloney - University of Southern Queensland
- Publication Details
- Educational Research Review
- Publisher
- Elsevier
- Identifiers
- 991013353272602368
- Academic Unit
- Faculty of Health
- Language
- English
- Resource Type
- Preprint