Practice points It is important to always evaluate the quality of a high stakes assessment, such as an OSCE, through the use of a range of appropriate metrics. When judging the quality of an OSCE, it is very important to employ more than one metric to gain an all round view of the assessment quality. AbstractWith an increasing use of criterion based assessment techniques in both undergraduate and postgraduate healthcare programmes, there is a consequent need to ensure the quality and rigour of these assessments. The obvious question for those responsible for delivering assessment is how is this 'quality' measured, and what mechanisms might there be that allow improvements in assessment quality over time to be demonstrated? Whilst a small base of literature exists, few papers give more than one or two metrics as measures of quality in OSCEs.In this guide, aimed at assessment practitioners, the authors aim to review the metrics that are available for measuring quality and indicate how a rounded picture of OSCE assessment quality may be constructed by using a variety of such measures, and also to consider which characteristics of the OSCE are appropriately judged by which measure(s). The authors will discuss the quality issues both at the individual station level and across the complete clinical assessment as a whole, using a series of 'worked examples' drawn from OSCE data sets from the authors' institution.

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With growing evidence for the positive health outcomes associated with a plant-based diet, the study’s purpose was to examine the potential of shifting adolescents’ food choices towards plant-based foods. Using a real world setting of a school canteen, a set of small changes to the choice architecture was designed and deployed in a secondary school in Yorkshire, England. Focussing on designated food items (whole fruit, fruit salad, vegetarian daily specials, and sandwiches containing salad) the changes were implemented for six weeks. Data collected on students’ food choice (218,796 transactions) enabled students’ (980 students) selections to be examined. Students’ food choice was compared for three periods: baseline (29 weeks); intervention (six weeks); and post-intervention (three weeks). Selection of designated food items significantly increased during the intervention and post-intervention periods, compared to baseline (baseline, 1.4%; intervention 3.0%; post-intervention, 2.2%) χ2(2) = 68.1, p < 0.001. Logistic regression modelling also revealed the independent effect of the intervention, with students 2.5 times as likely (p < 0.001) to select the designated food items during the intervention period, compared to baseline. The study’s results point to the influence of choice architecture within secondary school settings, and its potential role in improving adolescents’ daily food choices.

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