PURPOSE:
The Objective Structured Clinical Examination (OSCE) method is internationally recognized as the gold standard for assessing clinical competencies due to its higher reliability and objectivity compared to traditional oral or written examinations. Its structured and standardized format ensures equal assessment conditions, reduces assessor bias, and allows for the evaluation of a broad range of competencies through realistic scenarios. Until recently, the OSCE method had not been used as a final qualification exam in midwifery education in Estonia.

DISCUSSION:
In 2025, the OSCE was implemented for the first time at the Tartu Health Care College as the final professional examination for midwifery students. Sixteen students participated, of whom thirteen successfully passed all four stations by exceeding the required 51% threshold. The exam consisted of four independent simulated stations evaluating various midwifery competencies, including labor management, postpartum counselling, breastfeeding, and high-risk pregnancy care. Each station was 35 minutes long (5 minutes for briefing and 30 minutes for task performance), with two assessors present – one faculty member and one practicing midwife – scoring performance on a 0–2 scale using standardized checklists.

EVIDENCE WHERE RELEVANT:
The exam placed emphasis not only on technical skills but also on communication and empathy. Students performed best in labor management and breastfeeding tasks, while postpartum counselling and high-risk pregnancy stations proved more challenging, particularly in areas such as mental health support and contraceptive counselling. Assessors praised students' professional interaction but noted a need for improved reflection and real-time feedback.

KEY MESSAGE:
Implementation highlighted several challenges, including scenario realism, actor training, and maintaining consistent scoring. Nevertheless, the OSCE provided valuable insight into the strengths and weaknesses of current training. In conclusion, the OSCE format proved to be a suitable and effective method for assessing midwifery competencies and offered meaningful input for further curriculum development to better support student growth and patient-centered care. Poster session 3 (Group B)