OSCE Station Checklist: What Examiners Score and How to Build Your Own

Published · By VMS, Alehundred Studios

An OSCE station checklist is the list of specific, observable actions an examiner ticks off while you work through one station: introduce yourself, confirm the patient's identity, wash your hands, ask about allergies, auscultate four areas, explain the next step. Each item is done or not done, sometimes with a middle grade for done poorly, and the items add up to your station score. Below is what goes on a typical checklist, how it differs from a global rating, where to find OSCE checklists, how to build your own from the AAMC EPA 1 behaviors, and OSCE scenarios with answers, including one for medical-surgical nursing.

What is an OSCE station checklist?

An OSCE station checklist is the scoring sheet for a single station, written as a list of actions the examiner can see or hear you perform.

The person holding the checklist is not always a faculty member. The Association of Standardized Patient Educators (ASPE) standards note that "SPs often portray a role and observe behavior simultaneously," and that "After an encounter, SPs may document learner performance on assessment instruments."

Checklists differ in how they grade each item:

On a graded checklist, a step done out of sequence costs you points even when you do it.

What is on a typical OSCE station checklist?

Most checklists have three blocks: universal opening items, task-specific items, and closing items. The opening and closing blocks are nearly identical across stations, so they are the cheapest points you will ever earn.

Opening (every station):

  1. Introduces self with name and role.
  2. Confirms the patient's name and date of birth.
  3. Explains the task and gains consent.
  4. Washes hands or uses hand sanitizer; puts on gloves when needed.
  5. Ensures privacy and comfort (door, drape, position).

Task-specific (changes with the station): the history questions, exam maneuvers or procedure steps the station tests, usually in a fixed sequence.

Closing (every station):

  1. Summarizes findings to the patient in plain language.
  2. Explains the next step and asks whether the patient has questions.
  3. Thanks the patient and washes hands.
  4. Presents findings or a working diagnosis to the examiner, when asked.

How is a checklist different from a global rating?

A checklist scores each action you perform, while a global rating scores the examiner's overall judgment of the encounter, such as fail, borderline or pass. Most programs use both. In the BMC Nursing program, "Calculating an OSCE station score is based on combining the results of the binary structured checklist, 90%; and the global-rating scale, 10%."

The two do not always agree. A 2026 study of a 15-station exit OSCE in Rwanda, published in BMC Medical Education, found that checklist and global scores correlated strongly, but the global rating "showed a higher discriminatory ability, identifying performance differences that checklists did not capture." No student failed a station on the checklist, while the global rating flagged failures at four stations.

The authors also list a known limit of checklists: "the potential for students to master the checklists over time without detailed knowledge." The lesson: learn the checklist so the routine items run on autopilot, then spend your attention on reasoning, order and the patient. That is what the global rating rewards. For more on scoring, see our OSCE exam tips.

Where can I find OSCE checklists?

The best OSCE checklists come from your own program, because they follow your course objectives and your school's version of each station. Ask which stations you will face and whether the scoring criteria are shared.

Three public sources give you the raw material:

  1. The AAMC Core EPAs. The AAMC Core EPA 1 toolkit, "Gather a History and Perform a Physical Examination," lists the behaviors of a student who can be trusted with that task. It underpins most history and physical stations for MD, DO and PA students.
  2. The NCLEX test plans for nurses. The 2026 NCLEX-RN Test Plan lists activities such as "Properly identify client when providing care" and "Prepare and administer medications using rights of medication administration." Each one converts into checklist items.
  3. Published OSCE studies. Their methods sections describe stations and scoring rules.

How do you build your own OSCE checklist from the AAMC EPA 1 behaviors?

You build your own checklist by turning each AAMC EPA 1 behavior into one observable action you can mark as done or not done. The AAMC states that its schematic "is not intended for use as an assessment instrument," so treat it as a source of items, not a ready-made form.

  1. Pick one station, such as a focused history for chest pain or a cardiac exam.
  2. Copy the entrustable behaviors. EPA 1 lists them in its last column, including "Obtains a complete and accurate history in an organized fashion," "Performs an accurate exam in a logical and fluid sequence" and "Demonstrates astute clinical reasoning through targeted hypothesis-driven questioning."
  3. Break each behavior into actions. An organized history becomes onset, location, character, radiation, severity, timing, aggravating and relieving factors, associated symptoms, past history, medications, allergies and social history. A logical exam becomes inspect, palpate, then auscultate.
  4. Add the corrective items as traps. EPA 1 lists "Does not consider patient's privacy and comfort during exams" and "Incorrectly performs basic physical exam maneuvers" as behaviors that need correction.
  5. Anchor every item. Write what "done" looks like, so a classmate scoring you cannot argue. A 2026 study in Perspectives on Medical Education built its checklist by "translating complex competencies into observable indicators with explicit performance-level descriptors," and reported "high internal consistency and acceptable inter-rater agreement."

Keep it short enough to score in real time: the Taiwan checklists used 10 to 12 items.

What do OSCE scenarios with answers look like?

An OSCE scenario with answers is a door note plus the checklist items that earn the marks. We wrote the two examples below as practice material; your school's version may differ.

Scenario 1: focused history for chest pain

Door note: Ms. Rivera, 58, has had chest pain for two hours. Take a focused history. You have 8 minutes.

Answer (checklist items):

  1. Opening items: introduction, identity, consent, hand hygiene.
  2. Onset, location, character, radiation, severity (0 to 10) and duration.
  3. Relation to exertion, rest, breathing, position and meals.
  4. Associated symptoms: shortness of breath, sweating, nausea, palpitations, dizziness or fainting.
  5. Risk factors: smoking, high blood pressure, diabetes, high cholesterol, family history of early heart disease.
  6. Past history, medications and allergies.
  7. Summary to the patient and an explanation that an ECG comes next.
  8. To the examiner: a prioritized differential with acute coronary syndrome first, and pulmonary embolism, aortic dissection, reflux and musculoskeletal pain considered.

Scenario 2: cardiovascular exam

Door note: Mr. Chen, 64, has been more short of breath for two weeks. Examine his cardiovascular system. You have 8 minutes.

Answer (checklist items):

  1. Opening items; positions the patient at about 45 degrees, chest exposed and draped appropriately.
  2. General inspection, hands, then radial pulse for rate and rhythm.
  3. Jugular venous pressure and the apex beat.
  4. Auscultates the aortic, pulmonic, tricuspid and mitral areas.
  5. Listens to the lung bases and checks the ankles for edema.
  6. Thanks and covers the patient, washes hands, summarizes findings.

For full exam sequences, see physical exam steps.

What is on an OSCE checklist for medical-surgical nursing?

An OSCE checklist for medical-surgical nursing scores the same opening and closing items, plus the safety, infection-control and documentation steps of a bedside task. Wound care is a revealing example. In a 2026 review of 324 nursing students' OSCE records in BMC Medical Education, students did well on "identifying patients, communication, proper glove usage, and preparing a sterile field," yet "final hand washing and mask utilization, were often neglected," and the authors note "The very low rate of documenting the date on dressings."

Example station (written for this article): Mrs. Okafor, postoperative day 2 after abdominal surgery. Change her dry abdominal dressing.

  1. Checks the order and gathers supplies.
  2. Introduces self; identifies the patient with two identifiers.
  3. Explains, gains consent, provides privacy.
  4. Hand hygiene and clean gloves; removes the old dressing and discards it with the gloves.
  5. Assesses the incision: edges, redness, swelling, drainage (amount, color, odor) and pain.
  6. Hand hygiene again; redresses using aseptic technique per facility policy.
  7. Labels the dressing with date, time and initials.
  8. Final hand hygiene; patient comfortable, call light in reach.
  9. Teaches signs of infection to report.
  10. Documents the wound assessment and care.

Items 6 to 10 are where the Tehran students lost points. For more nursing stations with sample questions and model answers, see OSCE stations for nurses.

How should you practice with an OSCE checklist?

Practice with the checklist in someone else's hands. Run the station on a timer while a classmate scores you, then switch roles; scoring others shows you what examiners notice.

Clear checklists produce consistent scores. In a nursing study in BMC Nursing, six station rubrics tested in a mock OSCE reached kappa coefficients of 0.86 to 0.91, where "A kappa result of 0.81–1.00 indicated almost perfect agreement." Brief your classmates on each item before they score you, and after each run ask for one global impression: did the encounter feel organized and caring?

How does VMS use the OSCE station checklist?

VMS, the Virtual Medical Simulator, runs every case as an OSCE station with a step-by-step checklist and a score from 0 to 100%. You choose your program (Medicine for MD and DO, Physician Assistant, Nursing for RN, PN and NP, or EMS for EMT and Paramedic), so the checklist matches your exams.

The checklist follows a real station: introduce yourself, gain consent, wash your hands or put on gloves, examine the patient with your hands (palpate, auscultate, take a pulse) and with tools such as the stethoscope and reflex hammer, and close the encounter. Teach, Train and Test modes take you from guided practice to a scored attempt, and the OSCE exam button picks a random patient from your program and starts it in Test mode, with no hints and a time limit. Attempts are saved to your account, and educators can set up cases on the web and see results per student. Each case shows the exam content areas it trains, such as the AAMC Core EPAs. VMS runs on PC with mouse and keyboard and in VR with a laser pointer, solo or in multiplayer with your class.

VMS comes with 3 free cases, so you can try the whole workflow without paying. A subscription unlocks every case, and a subscriber can share their cases with friends or classmates in multiplayer, as long as the subscriber hosts the session and stays connected.

FAQ

Where can I find OSCE checklists?

Start with your own school, because its checklists follow its course objectives. For history and physical stations, use the AAMC Core EPA 1 toolkit; for nursing, the activities in the NCLEX-RN Test Plan. In VMS, every case comes with its own checklist. For station types, see our guide to OSCE stations.

How many items are on an OSCE station checklist?

It varies. One nursing OSCE used 10 to 12 items per station, each rated 0, 1 or 2, and a medical exit OSCE scored each station out of 20 marks.

Is there an OSCE checklist for medical-surgical nursing?

Yes. Medical-surgical nursing stations use checklists built around patient identification, infection control, assessment, teaching and documentation, as in the wound care example above.

Are there OSCE scenarios with answers?

Yes: the two scenarios above list the items that earn marks. Write your own as a door note plus 8 to 12 observable actions.

Which counts more, the checklist or the global rating?

Usually the checklist: one nursing program weights it at 90% and the global rating at 10%. The global rating still matters, because it can catch weak performances the checklist misses.

Can I practice with an OSCE checklist for free?

Yes. Write a checklist from the AAMC EPA 1 behaviors, set a timer and have a classmate score you. VMS comes with 3 free cases, so you can try the whole workflow without paying. A subscription unlocks every case, and a subscriber can share their cases with friends or classmates in multiplayer, as long as the subscriber hosts the session and stays connected.

Sources

  1. Lewis KL, Bohnert CA, Gammon WL, et al. The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP). Advances in Simulation, 2017.
  2. Avraham R, Cohen T, Artzi-Medvedik R, Hurvitz N, Cohen O. Effectiveness of a virtual program for OSCE preparation during COVID-19: a descriptive and repeated cross-sectional study among nursing students. BMC Nursing, 2023.
  3. Chen SH, Chen SC, Lai YP, Chen PH, Yeh KY. The objective structured clinical examination as an assessment strategy for clinical competence in novice nursing practitioners in Taiwan. BMC Nursing, 2021.
  4. Ibrahim OR, McCall N, Bekele A, et al. Agreement and reliability of global rating versus checklist scores in a high-stakes undergraduate OSCE in Rwanda. BMC Medical Education, 2026.
  5. Association of American Medical Colleges. Core EPAs for Entering Residency: EPA 1 Toolkit, Gather a History and Perform a Physical Examination. AAMC, 2017.
  6. National Council of State Boards of Nursing. 2026 NCLEX-RN Test Plan. NCSBN, 2026.
  7. Nakamura Y, Mori S, Kijima S, Tanaka M, Taguchi O. A Behaviourally Anchored Checklist for Mental Health Occupational Therapy Intake Interviews: Development and Reliability in a Single-Station Standardised Patient Encounter. Perspectives on Medical Education, 2026.
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