The Surgical Objective Structured Clinical Examination: A Literature Review

As competency-based medical education (CBME) gains prominence, assessment tools that integrate both theoretical knowledge and technical skill have become essential, particularly in surgical training. Traditional tools such as the objective structured clinical examination (OSCE) and the Objective Structured Assessment of Technical Skills (OSATS) are limited in scope, prompting the development of the Surgical Objective Structured Clinical Examination (S-OSCE). The S-OSCE integrates knowledge-based and technical assessments to align with competency-based medical education (CBME) goals, including those outlined in the CanMEDS and ACGME frameworks. This review examines S-OSCE implementation and highlights trends that can inform future assessment strategies in surgical curricula.

A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus using defined keywords. Inclusion criteria encompassed all surgical disciplines and study designs that employed both theoretical and technical assessments. After screening 1101 articles, 16 studies were identified that met the inclusion criteria for S-OSCEs.

The 16 studies spanned 6 specialties: general surgery, orthopedics, obstetrics and gynecology, oral and maxillofacial surgery, otolaryngology, and thoracic surgery. Most employed multiple-choice or short-answer theoretical assessments (n=12) and practical evaluations using OSATS or global rating scales (n=9). Video-based assessments were increasingly incorporated to reduce evaluator bias and logistical barriers. Canadian programs conducted the highest proportion of studies (37.5%).

S-OSCEs show strong potential to provide valid and reliable assessment of surgical competency. However, widespread adoption is limited by logistical, financial, and staffing constraints. Video-based formats offer a promising solution, allowing asynchronous review and enhanced feedback while reducing costs and time requirements.

S-OSCEs offer a comprehensive framework for evaluating surgical trainees across theoretical and technical domains. Future research should focus on validating scalable models, particularly those incorporating video-based assessment, to support broader integration into surgical training programs.