standard setting methods in objective structured clinical examination (osce): a comparative study of five methods

Background & objective: objective structured clinical examination (osce) is a crucial component in medical school examinations to assess students’ competency, particularly in clinical skills incorporating cognitive and affective domains. osce results are subjected to standard-setting methods, which yield different findings. hence, in this study, five different standard-setting methods, namely norm reference, angoff method, borderline group method (bgm), borderline regression method (brm), and modified cohen’s method, were compared to determine the cut-off scores and failure rates determined by each method.material & methods: data of 170 second-year medical students who attended osce with eight stations for their first professional examination at the end of year 2 mbbs was taken for the study following ethical approval. total scores for each station were standardized to 20 marks, and cut-off scores were determined using each of the five standard-setting methods.results: as a comparison of 5 methods, the norm reference method yielded the highest number of stations with high cut-off scores, followed by brm. this is reflected in the number of failures, too. on the contrary, using the angoff method yielded the lowest cut-off scores in maximum stations, resulting in the least number of failed students. the cochrane’s q test of the results yielded a p < 0.001, which signifies that the proportion of students who failed a particular osce station was significantly different when different methods were used to determine the cut score.conclusion: the study, which compared 5 common standard-setting methods employed in medical education assessments, found that norm-referenced and brm had high cut-off scores and failures, with the opposite determined by the modified angoff method. the study concluded that the cut-off score and failure rate differed with different standard-setting methods, and the choice of the method is contextual depending on the available resources.