Can student tutors act as examiners in an objective structured clinical examination? Jean-Franc ¸ ois Chenot, 1 Anne Simmenroth-Nayda, 1 Alexandra Koch, 1 Thomas Fischer, 1 Martin Scherer, 1 Birgit Emmert, 2 Beate Stanske, 3 Michael M Kochen 1 & Wolfgang Himmel 1 CONTEXT The dissemination of objective structured clinical examinations (OSCEs) is hampered by requirements for high levels of staffing and a signif- icantly higher workload compared with multiple- choice examinations. Senior medical students may be able to support faculty staff to assess their peers. The aim of this study is to assess the reliability of student tutors as OSCE examiners and their acceptance by their peers. METHODS Using a checklist and a global rating, teaching doctors (TDs) and student tutors (STs) simultaneously assessed students in basic clinical skills at 4 OSCE stations. The inter-rater agreement between TDs and STs was calculated by kappa values and paired t-tests. Students then completed a questionnaire to assess their acceptance of student peer examiners. RESULTS All 214 Year 3 students at the University of Go ¨ttingen Medical School were evaluated in spring 2005. Student tutors gave slightly better average grades than TDs (differences of 0.02–0.20 on a 5-point Likert scale). Inter-rater agreement at the stations ranged from 0.41 to 0Æ64 for checklist assessment and global ratings; overall inter-rater agreement on the final grade was 0.66. Most students felt that assessment by STs would result in the same grades as assessment by TDs (64%) and that it would be similarly objective (69%). Nearly all students (95%) felt confident that they could evaluate their peers themselves in an OSCE. CONCLUSIONS On the basis of our results, STs can act as examiners in summative OSCEs to assess basic medical skills. The slightly better grades observed are of no practical concern. Students accepted assessment performed by STs. KEYWORDS educational measurement ⁄ *methods; *education, medical, undergraduate; *peer review; *teaching; Germany; *students, medical; observer variation. Medical Education 2007: 41: 1032–1038 doi:10.1111/j.1365-2923.2007.02895.x INTRODUCTION The objective structured clinical examination (OSCE) is considered to be one of the most adequate formats for assessing clinical skills and has gained widespread distribution since its introduction. 1 Con- siderable variability has been observed in how med- ical schools assess clinical skills. 2 Although OSCEs are used as substantial part of the licensure process in some countries, the OSCE has never become very popular in other countries outside small reform universities or ephemeral attempts at some larger medical schools. High staff requirements, high time expenditure and considerable costs have prevented its introduction. 3,4 Multiple-choice and oral examinations are still the most commonly used assessment formats. The new curriculum for medical schools introduced in Germany in 2004 places more emphasis on clinical skills. 5 As a result, we introduced a clinical skills course, which combines training in procedural skills assessment 1 Department of General Practice, University of Go ¨ttingen, Go ¨ ttingen, Germany 2 Department of Occupational Medicine, University of Go ¨ ttingen, Go ¨ttingen, Germany 3 Department of Psychosomatic Medicine and Psychotherapy, University of Go ¨ttingen, Go ¨ ttingen, Germany Correspondence: Dr Jean-Franc ¸ois Chenot, Department of General Practice, University of Goettingen, Humboldtallee 38, 37073 Goettingen, Germany. Tel: 00 49 551 396599; Fax: 00 49 551 399530; E-mail: jchenot@gwdg.de Ó Blackwell Publishing Ltd 2007. MEDICAL EDUCATION 2007; 41: 1032–1038 1032