Evaluation of a Professionalism and Ethics OSCE (PESCE) to Navigate Ethically Challenging Situations

Although professionalism and ethics are core competencies in medical education, assessing students' preparedness for ethically challenging situations remains difficult. The aims of this study were to (1) assess student preparedness for ethical dilemmas in practice, (2) pilot a training day and examine its impact on students' preparedness and (3) evaluate students' performance in OSCE stations.

We developed a Professionalism and Ethics Simulation Clinical Examination (PESCE) for Year 4 medical students. Following a preparatory session, students rotated through simulated clinical scenarios reflecting common ethical challenges encountered by junior doctors before undertaking a formative OSCE station.

Preintervention and postintervention surveys demonstrated increased preparedness for ethical dilemmas (mean 3.08 to 3.89, p < 0.001). Students valued the realism and opportunity for rehearsal. Assessor feedback identified strong empathy and professionalism but difficulty articulating procedural next steps.

Integrating ethics-focused simulation into OSCE assessment offers a practical way to strengthen engagement with ethics and professionalism. It aligns with workplace-based learning and better prepares students for everyday ethical encounters in clinical practice.