Is quarantining in medical training fit for purpose?

Quarantining students before or after an Objective Structured Clinical Examination is a common practice in medical training intended to prevent information sharing and increase fairness in assessment. However, evolving student needs and resource limitations leave many educators asking whether this approach is still the way forward. This resource draws on literature and student feedback to provide answers.

Why use quarantining?

If you are considering making changes to quarantining processes, first be explicit about what problem quarantining should address.

Bear in mind the following:

• Without quarantining, students do sometimes share OSCE station information.
• In experimental contexts, previous knowledge of OSCE station content can improve performance.
• In reality, the impact of information sharing in undergraduate OSCEs appears minimal, inconsistent and limited to specific stations or subgroups. 
• The perception that quarantine improves fairness holds weight.

What does this mean for educators? We must recognise quarantining as one component of assessment integrity, not the only solution, and avoid assuming that quarantining equalises performance across an entire cohort.

The importance of examiner induction and station design

Being strategic about how the examination space is set up and how students move through it can make a huge difference. We must take action to ensure that exam invigilators are well briefed and that stations are designed to reduce the risk of information sharing. Consider the following:

• Prioritise examiner induction, calibration (pre-station standardisation meetings) and station-specific briefings at least as highly as quarantine logistics. Calibration trumps moderation, so give this task time.
• Ensure all stations are fit for purpose by pilot testing and reviewing them in advance.
• Consider blueprinting (mapping of assessment to learning outcomes) and station rotation strategies (random allocation or mixing of OSCE stations) as complementary or alternative risk‑mitigation tools, since they reduce predictability during assessments.

Interpret student feedback carefully

Feedback from our students shows that:

• Most students accept quarantining, even if they do not enjoy it.
• Many believe it improves fairness and reduces information sharing.
• Only a minority view the experience positively.

This highlights an important distinction between perceived fairness and measurable impact.

What does this mean in practice?

• We must recognise the value in students’ trust in assessment processes, particularly in high‑stakes contexts, and make quarantine experiences as positive as possible to counter their negative effects. 
• We must clearly communicate the reasons for quarantining and its limitations to challenge students’ assumptions.

Mitigate quarantining’s negative impacts on well-being 

Prolonged quarantine periods can be stressful. Students already find it difficult to disengage after their OSCEs, and when confined with peers, conversations can easily slip into discussions around performance.

To prevent this, minimise quarantine duration wherever feasible (for example, favour half- over whole‑day isolation periods) and tell students when isolation will end. Also, consider only using quarantining for summative assessments.

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Students’ quarantining experience is shaped by various physical and social conditions. Poorly designed environments can feel noisy and claustrophobic and group dynamics can lead to isolation. Small adjustments can make a big difference:

• Avoid overcrowded spaces where possible.
• Establish separate zones for quiet rest and low‑key conversation.
• Provide reading materials and activities such as puzzles.
• Where feasible, allow supervised outdoor or movement breaks.

Weigh institutional cost against visible benefit

Quarantining requires space, staffing and time – often across long OSCE days. When its performance impact is uncertain, proportionality becomes an important consideration.

• Review quarantining alongside other resource‑intensive practices using the same evidence thresholds.
• Ask whether equivalent investment elsewhere (for example, in examiner support, station review and post‑exam feedback) would yield greater educational value.
• Build periodic review of quarantining into routine assessment evaluation, rather than treat it as fixed infrastructure.
• Regularly collect and respond to student feedback.

We should view quarantining as a reassurance tool rather than an evidence‑backed performance leveller. That does not make it redundant – but it does mean it should be intentionally designed, proportionate and regularly reviewed. This is especially important with student well-being at risk and institutional resources at a premium. Fairness in OSCEs depends on multiple interacting factors. Quarantining may play a role, but it is only one part of a much larger process, and we should treat it as such.

Rebekah Hill is an associate professor of nursing and medical education at the University of East Anglia.

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