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Remediating Students Failed OSCE Performances at One School: The Effects of Self-Assessment, Reflection, and Feedback

White, Casey B. PhD; Ross, Paula T. MA; Gruppen, Larry D. PhD

doi: 10.1097/ACM.0b013e31819fb9de
Students' Academic Performance

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.

Dr. White is assistant dean for medical education and assistant professor of medical education, University of Michigan Medical School, Ann Arbor, Michigan.

Ms. Ross is research associate, University of Michigan Medical School, Ann Arbor, Michigan.

Dr. Gruppen is Josiah Macy, Jr. Professor of Medical Education and chair, Department of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan.

Correspondence should be addressed to Dr. White, University of Michigan Medical School, 1135 E. Catherine St., Ann Arbor, MI 48109-5726; telephone: (734) 763-6770; fax: (734) 763-6771; e-mail: (

Editor’s Note: Commentaries on this article appear on pages 545 and 548.

© 2009 Association of American Medical Colleges