Background: In 1979, Harden described the first objective structured clinical examination (OSCE). Harden's OSCE dramatically changed the assessment of professional competence because it used actors and choreographed scenarios to evaluate the performance of professional behaviours.
Analysis: Because of the intense focus on performance, OSCEs have had a powerful influence on doctor training and practice. However, the immediate psychometric characteristics of OSCEs rather than their performance effects have been the subject of most research.
Conclusion: The time has come to undertake a sophisticated sociological investigation of how OSCEs affect medical practice, including the ways in which they shape doctor interaction with patients, families and other health professionals.