Utility and feasibility of Objective Structured Practical Examination for formative assessment in physiology: a mixed-methods study from India

Objective Structured Practical Examination (OSPE) is a structured, competency-based method for assessing practical skills. While OSPE is well established in clinical settings as Objective Structured Clinical Examination (OSCE), its feasibility and utility for formative assessment in preclinical subjects like Physiology in India remain underexplored. The aim of the study was to evaluate the feasibility, utility, and student perceptions of OSPE as a formative assessment tool for practical Physiology competencies. This mixed-methods study was conducted among 100 first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students. Two OSPE assessments were conducted 1 mo apart. Core certifiable competencies on blood pressure measurement and neurological examination were assessed. Quantitative analysis compared student scores across both assessments. Student perceptions were documented using a feedback questionnaire. Narrative feedback from students was analyzed through thematic analysis. Students performed better on their second OSPE assessment than the first one (<i>P</i> < 0.001) for all but one of the six questions. This may partly reflect a testing effect from reassessment of similar competencies. Questionnaire responses indicated strong agreement on OSPE's fairness (80%) and relevance (97.3%), with 81.3% advocating for its regular use. Thematic analysis highlighted strengths such as objectivity and skill focus, alongside weaknesses (time constraints and limited feedback) and threats (logistical challenges and subject cooperation). OSPE is a feasible and effective formative assessment tool for Physiology within the Indian Competency Based Medical Education (CBME) framework. This work adds context-specific insights from a resource-constrained Indian setting, offering practical directions for sustainable OSPE integration.<b>NEW & NOTEWORTHY</b> This study from India evaluates the impact of repeated formative Objective Structured Practical Examinations for assessing physiology competencies under the newly implemented Competency-Based Medical Education curriculum. Using a mixed-methods design, it demonstrates that OSPE not only improves student performance but is also perceived as fair, relevant, and skill oriented. Importantly, the study highlights the possible influence of the testing effect on performance gains and identifies context-specific challenges such as time constraints, subject cooperation, and logistical demands.