Applying borderline methods for setting standards in Objective Structured Clinical Examination: the first case in an undergraduate medical program in Vietnam

<b>Abstract</b><b>Introduction:</b> Many medical schools in Vietnam have frequently used the arbitrary 50% score of the checklist as passing scores in objective structured clinical examination (OSCE). As part of the competency-based education, we apply the borderline methods in this study to determine OSCE passing scores and to demonstrate whether cut-off scores of borderline methods significantly differ from the arbitrary 50% score.<b>Methods: </b>This descriptive study applied the Borderline Group Method (BGM) and Borderline Regression Method (BRM) to determine OSCE passing scores. Our OSCE exam consisted of five stations and was administered to 406 second-year medical students (MS2) in 2023. At each station, an examiner rated a checklist score and a global score. We use paired t-tests for the comparison of passing scores between scores of 50%, borderline group mean, borderline group median, and BRM scores.<b>Results:</b> The ranges of passing scores calculated according to the mean of BGM and BRM at 5 stations were 68-86.5 and 69.3-86.3, respectively. There was a statistically significant difference in passing scores between the 50% score and the mean/median of BGM as well as BRM (p=0.000) by paired t-test. There was no significant difference in passing scores between the mean or median of BGM and BRM (p=0.307 and p=0.921).<b>Conclusion: </b>The passing scores determined by borderline methods were significantly higher than the arbitrary 50% score of the checklist. Borderline methods can be used as appropriate standard-setting methods for OSCE in MS2 and should be implemented in OSCEs for subsequent-year medical students at our university.