Abstract

Objective Structured Clinical Examinations (OSCEs) are widely used
in healthcare education to assess students’ clinical, communication, and
decision-making skills (Miller, 1990). They are designed to simulate
real-world clinical scenarios, allowing students to demonstrate their
competence in a structured and standardised manner. OSCEs aim to
provide an objective and reliable assessment of clinical skills, ensuring
that students meet the required professional standards before pro�gressing in their training.
However, their structure and implementation raise significant con�cerns about fairness, equity, inclusivity, and cultural competence
(Kumagai and Lypson, 2009; Tervalon and Murray-García, 1998). Like
all examinations they have the potential to promote learning-by-rote. As
identified by Tai et al. (2022), assessment in higher education should be
designed in such a way that it enables students to achieve and demon�strate capability in an equitable manner and that students from
widening participation backgrounds are not disadvantaged because of
characteristics or abilities extraneous to the competencies under
scrutiny.
This paper critically examines how OSCEs may disproportionately
disadvantage students from diverse backgrounds due to embedded
biases, inflexible criteria, and a failure to reflect the realities of patient�centred care in a global context.