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J Educ Eval Health Prof. 2017;14(1):34. English. Original Article.
Chong L , Taylor S , Haywood M , Adelstein BA , Shulruf B .
Clinical Skills Teaching Unit, Prince of Wales Hospital, Sydney, Australia.
Office of Medical Education, University of New South Wales, Sydney, Australia.
University of New South Wales, Sydney, Australia.
Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand.


The objective structured clinical examination (OSCE) is considered to be one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners' assessment scores are influenced by several factors that may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners' assessments.


We performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed, with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area.


OSCE examiners' assessment scores are influenced by factors belonging to 4 different domains: examination context, examinee characteristics, examinee-examiner interactions, and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects; the examiner's gender and ethnicity; training; lifetime experience in assessing; leadership and familiarity with students; station type; and site effects.


Several factors may influence the presumed objectivity of examiners' assessments, and these factors need to be addressed to ensure the objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.

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