Implementing and Refining a Multilingual OSCE During Wartime: A Ukrainian Case Study

Background Objective Structured Clinical Examinations (OSCEs) are widely used for performance-based assessment; however, evidence on their implementation during prolonged disruption is limited. This study examined the implementation and progressive refinement of a multilingual OSCE for international medical students at a Ukrainian medical university operating under wartime conditions. Methods A multi-source educational evaluation was conducted at Dnipro State Medical University following OSCE pilot implementation in 2022 and three examination cycles from 2023 to 2025. The ten-station OSCE assessed final-year international medical students in English- and French-language programmes. The data included aggregate OSCE performance, KROK-2 licensing examination results, student evaluations and institutional quality-assurance documentation. Quantitative data were analysed descriptively, while quality-assurance documentation and open-ended feedback were reviewed to identify recurring priorities and changes across examination cycles. Results Overall, 409 international medical students participated. Good or Excellent OSCE performance increased from 78.4% in 2023 to 80.0% in 2025, while mean scores increased from 153.3 to 163.0. KROK-2 performance also increased across the four clinical disciplines examined; these trends were considered contextual and were not attributed causally to OSCE implementation. In 2025, 66/80 students completed the anonymous evaluation questionnaire (82.5%), with an overall satisfaction of 8.61/10. Across successive cycles, core assessment principles were retained while operational processes were adapted through contingency planning, multilingual standardisation, flexible workflows and iterative quality improvement. Conclusions This study illustrates the feasibility of maintaining and progressively refining a multilingual, high-stakes OSCE during prolonged wartime disruptions. Assessment continuity may depend on preserving core assessment principles while adapting operational processes to the changing circumstances. The findings do not establish causal effectiveness or equivalence across cohorts or languages but provide practical lessons for maintaining performance-based assessment during major educational disruption.