Objective Structured Clinical Examinations in Radiology and Medical Imaging Education: Educational Effectiveness, Validity, and Implementation—A Systematic Review

Rationale and Objectives To synthesize evidence on objective structured clinical examinations (OSCEs) in radiology and medical imaging education, focusing on educational outcomes, validity evidence, reliability, scoring, feasibility, and implementation consequences. Materials and Methods PubMed/MEDLINE, ERIC, Embase, and Web of Science were searched from inception to July 20, 2026. Eligibility was limited to radiology, radiography, nuclear medicine, sonography, and medical student imaging curricula; clinician bedside POCUS courses outside radiology or medical imaging education were excluded. Educational-effect studies were appraised with MERSQI. Measurement evidence was appraised across seven validity and implementation domains. Meta-analysis was considered only for sufficiently comparable independent studies. Results Forty-three reports met the narrowed scope: 22 measurement/implementation reports and 21 educational-effect reports. Educational studies comprised six randomized studies, nine nonrandomized comparisons, one pre-post study, and five post-course or implementation studies. Seven reports favored the intervention, one met a noninferiority criterion, one was mixed, six were uncertain, and six were not estimable as comparative effects. MERSQI scores ranged from 10.5 to 14.0. Feasibility was documented in all measurement reports, but internal-structure or reliability evidence was absent in ten, and consequence evidence was strong in only one. Conclusion Imaging-focused OSCEs are feasible and useful for local assessment in radiology and medical imaging education, but evidence remains heterogeneous and incompletely supported by reliability, response-process, and consequence data.