# Impact of a one-time formative OSCE on learning behavior and self-assessment in dental undergraduate education

## TL;DR

A formative OSCE early in dental education helps students assess their learning and prepare better for exams, though it doesn't make them start studying earlier.

## Contribution

The study introduces an early formative OSCE to improve dental students' self-assessment and learning behavior under reduced training time.

## Key findings

- Students in the intervention group showed higher initial motivation and greater awareness of knowledge gaps after the OSCE.
- The formative OSCE improved students' self-assessment and reflection on learning behavior.
- There was no significant difference in the timing of exam preparation between the groups.

## Abstract

With the introduction of the new dental licensing regulations (ZApprO) in Germany, preclinical teaching time was substantially reduced, particularly affecting practical training. To support students’ learning under these conditions, a formative Objective Structured Clinical Examination (OSCE) was implemented early in the preclinical curriculum. This study aimed to evaluate the impact of an early formative OSCE on undergraduate dental students’ learning behavior, self-assessment, and exam preparation.

A total of 71 undergraduate dental students (mean age 22 years) participated voluntarily in a formative OSCE in preventive dentistry during the summer semester 2022 and winter semester 2022/23. Students were randomly assigned to an intervention group (OSCE halfway through the semester) or a control group (OSCE shortly before the final exam). The OSCE included five stations developed according to the National Competence-Based Learning Objectives Catalog for Dentistry. Students completed pseudonymized questionnaires at two time points (T0: after OSCE; T1: after the final exam). The questionnaire assessed learning behavior (including strategies for dealing with difficult material and use of additional resources), self-assessment (perceived learning status and exam readiness), motivation, and exam preparation. Statistical analyses were performed using Mann–Whitney U and Wilcoxon tests.

Participation in the formative OSCE enabled students to better evaluate their learning status and identify individual learning needs for the final exam. Although both groups started exam preparation at similar times (T0: p = 0.422; T1: p = 0.674), the intervention group reported higher initial motivation and greater awareness of knowledge gaps after the OSCE. Differences were also observed in how students dealt with difficult material and in their use of supplementary learning resources.

An early formative OSCE fosters undergraduate dental students’ self-assessment, reflection on learning behavior, and awareness of learning needs, thereby supporting more targeted exam preparation. However, it does not necessarily lead to an earlier start of study activities. Implementing formative OSCEs in the middle of the semester, accompanied by structured feedback, may further enhance their educational impact.

The online version contains supplementary material available at 10.1186/s12909-025-08533-5.