Structured Peer-Evaluation Training in OSCE-Based Clinical Skills Education: A Non-Randomized Controlled Pilot Study

Abstract

BACKGROUND. Structured peer-evaluation is increasingly used as a formative strategy in medical education, but its value depends on structured implementation and appropriate student preparation. In clinical skills training, peer assessment may help students engage more actively with performance criteria, feedback, and professional behavior. OBJECTIVES. This pilot study explored whether structured peer-evaluation training was associated with changes in fourth- semester medical students' OSCE-based clinical skills performance, observed professional behavior, and alignment of peer– instructor assessments. METHODS. A prospective controlled pre–post pilot educational study was conducted at Ken Walker International University during one academic semester. Twenty-one fourth-semester medical students participated: 11 in the experimental group and 10 in the control group. The experimental group received structured peer-evaluation and feedback training after the midterm OSCE, while the control group received faculty assessment only. Students were assessed at midterm and final OSCEs using standardized clinical skills checklists and a professional behavior checklist. In the experimental group, peer and instructor ratings were also compared. Scores were converted into percentages and analyzed using exploratory pre–post and between-group comparisons. RESULTS. In the experimental group, faculty-assessed professional behavior improved from a median of 86.7% to 93.0%, while physical examination performance improved from 82.0% to 94.0%. The control group showed smaller, non-significant changes. However, between-group comparisons of change scores were not statistically significant. Peer ratings of professional behavior showed a stronger positive association with instructor ratings after training, whereas peer ratings of physical examination performance remained weakly associated with instructor ratings. CONCLUSIONS. Structured peer-evaluation training was feasible and associated with favorable within-group changes in professional behavior and physical examination performance. Findings suggest that students may assess observable professional behaviors more accurately than technical clinical skills. Because of the small sample size, non-random allocation, baseline imbalance, and variation in OSCE stations across time points, the results should be interpreted as preliminary and hypothesis- generating.