# Large Language Models for Medical OSCE Assessment: A Novel Approach to Transcript Analysis

arXiv: https://arxiv.org/abs/2410.12858 · HTML: https://mlsanity.com/paper/2410.12858/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 9 of its 25 references that are in the map.
- First posted on arXiv 11 Oct 2024.

## Builds on (most cited first, 9 of 9)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Robust Speech Recognition via Large-Scale Weak Supervision](https://mlsanity.com/paper/2212.04356/) (2022)
- [Retrieval-Augmented Generation for Large Language Models: A Survey](https://mlsanity.com/paper/2312.10997/) (2023)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [PaLM 2 Technical Report](https://mlsanity.com/paper/2305.10403/) (2023)
- [A Survey on Retrieval-Augmented Text Generation](https://mlsanity.com/paper/2202.01110/) (2022)
- [Efficient Few-Shot Learning Without Prompts](https://mlsanity.com/paper/2209.11055/) (2022)

## Built on by (most cited first, 3 of 3)

- [Benchmarking Generative AI for Scoring Medical Student Interviews in Objective Structured Clinical Examinations (OSCEs)](https://mlsanity.com/paper/2501.13957/) (2025)
- [LLM-Based Data Generation and Clinical Skills Evaluation for Low-Resource French OSCEs](https://mlsanity.com/paper/2604.08126/) (2026)
- [A French OSCE Dialogue Dataset and Controllable Virtual Patient System for Clinical Training](https://mlsanity.com/paper/2606.28526/) (2026)

## Abstract (arXiv)

Grading Objective Structured Clinical Examinations (OSCEs) is a time-consuming and expensive process, traditionally requiring extensive manual effort from human experts. In this study, we explore the potential of Large Language Models (LLMs) to assess skills related to medical student communication. We analyzed 2,027 video-recorded OSCE examinations from the University of Texas Southwestern Medical Center (UTSW), spanning four years (2019-2022), and several different medical cases or "stations." Specifically, our focus was on evaluating students' ability to summarize patients' medical history: we targeted the rubric item 'did the student summarize the patients' medical history?' from the communication skills rubric. After transcribing speech audio captured by OSCE videos using Whisper-v3, we studied the performance of various LLM-based approaches for grading students on this summarization task based on their examination transcripts. Using various frontier-level open-source and proprietary LLMs, we evaluated different techniques such as zero-shot chain-of-thought prompting, retrieval augmented generation, and multi-model ensemble methods. Our results show that frontier LLM models like GPT-4 achieved remarkable alignment with human graders, demonstrating a Cohen's kappa agreement of 0.88 and indicating strong potential for LLM-based OSCE grading to augment the current grading process. Open-source models also showed promising results, suggesting potential for widespread, cost-effective deployment. Further, we present a failure analysis identifying conditions where LLM grading may be less reliable in this context and recommend best practices for deploying LLMs in medical education settings.