OSCE Station Checklist Form
Use this form to review and assess candidate performance at an OSCE station. Complete all checklist items and provide your evaluation.
Candidate ID
*
Station ID/Name
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Checklist: Introduces self to patient
Completed
Checklist: Washes hands appropriately
Completed
Checklist: Explains procedure clearly
Completed
Checklist: Maintains patient safety
Completed
Checklist: Demonstrates correct technique
Completed
Overall Performance Rating
*
1
2
3
4
5
Observer Notes
Submit Checklist
Should be Empty: