John J. Dascanio

Establishing defensible minimum passing scores is a critical challenge in high-stakes objective structured clinical examinations (OSCEs). Direct comparisons of different standard-setting methods and the varying passing and failure rates remain limited in veterinary medical education. This observational, cross-sectional study compared minimum passing scores (MPSs) generated using the Angoff method, Hofstee method, and borderline regression method (BRM) for an integrated, summative veterinary OSCE. Eighty-one third-year veterinary students at Texas Tech University School of Veterinary Medicine completed a 13-station OSCE. Only 10 stations—3 communication and 7 clinical skills—incorporated both a checklist and a global rating scale and were included in these analyses. All stations were assessed by trained examiners. MPS values for Angoff and Hofstee judgments were provided by six external judges who received training on standard-setting methods. Passing thresholds were compared using descriptive statistics and repeated-measures ANOVA with Greenhouse–Geisser correction. Passing scores differed significantly across standard-setting methods ( p < .001). Angoff and BRM produced comparable and more stringent passing thresholds across stations, whereas Hofstee consistently generated lower cut-scores and fewer student failures. Pearson ( r = 0.60–0.86; p < .001) and Spearman correlation coefficients (ρ = 0.58–0.89; p < .001) demonstrated moderate to strong associations between checklist and global rating scores. These findings indicate that the choice of standard-setting methods substantially influences OSCE passing scores and pass–fail decisions. Careful selection and transparent application of standard-setting methods are essential to ensure fairness and defensibility in veterinary OSCEs.

Medical sciences education emphasizes basic science learning as a prerequisite to clinical learning. Studies exploring relationships between achievement in the basic sciences and subsequent achievement in the clinical sciences generally suggest a significant positive relationship. Basic science knowledge and clinical experience are theorized to combine to form encapsulated knowledge– a dynamic mix of information that is useful for solving clinical problems. This study explores the relationship between basic science knowledge (BSK), clinical science knowledge (CSK), and clinical problem-solving ability, as measured within the context of four veterinary colleges using both college-specific measures and professionally validated, standardized measures of basic and clinical science knowledge and problem-solving ability. Significant correlations existed among all variables. Structural equation modeling and confirmatory factor analysis were used to produce models showing that newly acquired BSK directly and significantly predicted BSK retained over time and newly acquired CSK, as well as indirectly predicted clinical problem-solving ability (mediated by newly acquired CSK and BSK retained over time). These findings likely suggest a gradual development of schema (encapsulated knowledge) and not an isolated development of biomedical versus clinical knowledge over time. A broader implication of these results is that explicitly teaching basic science knowledge positively and durably affects subsequent clinical knowledge and problem-solving ability independent of instructional strategy or curricular approach. Furthermore, for veterinary colleges specifically, student performance as measured by both course-level and standardized tests are likely to prove useful for predicting subsequent academic achievement in classroom and clinical settings, licensing examination performance, and/or for identifying students likely in need of remediation in clinical knowledge.