Cost Analysis of the OSCE: Scoping Review

SUMMARY STATEMENT: This scoping review examined the economic components of implementing Objective Structured Clinical Examinations (OSCEs) in health professions education. Forty-nine studies published between 1986 and 2024, spanning multiple countries, professions, and simulation modalities, were analyzed. Key cost categories included standardized patients, evaluator compensation, infrastructure, logistics, and digital resources. Reported costs ranged from less than US$7 per student to more than US$150,000 per cycle. Traditional in-person OSCEs incurred higher recurring operational expenses, whereas online and hybrid formats concentrated spending in initial infrastructure and showed potential for scalability and cost containment. Significant inconsistencies in cost definitions and reporting practices limited comparability across studies. The findings highlight the urgent need for standardized economic frameworks, cost-reporting tools, and context-sensitive strategies to guide sustainable OSCE implementation, particularly in low- and middle-income countries where resource allocation must be strategic and aligned with institutional capacity.