osce-assessment-shape

NDEB Virtual OSCE — Assessment Shape

Derived from Virtual-OSCE-Frameworks-2026.pdf by a full parse of all 112 pages: 102 frameworks, 237 question stems, 2,167 answer options. Counts are measured, not impressions.

This file is the verb bank every Curriculum note is written against. Mined once, reused for all 60 notes. It is data, not a note — it carries no frontmatter and is excluded from the audit.

The structural fact

The document contains no imperative verbs. Not one stem says “Identify…”, “Diagnose…”, “Interpret…”. The task is carried by the noun in an interrogative stem (“What is the most appropriate management…?”) or by a declarative stem-completion (“The die …” → “A. is clinically acceptable.”).

Literal counts, whole document: interpret 0 · recognize 0 · contraindication 0 · choose 0 · know 0 · understand 0 · explain 0 · list 0. diagnose 0 as a verb (66× the noun diagnos*); manage 0 as a verb (68× the noun management); prescribe 5, all in answer options, never in a stem; select 167, of which 165 are the exam directive “Select ONE correct answer”.

So the verb bank below is derived from what the candidate must produce. All 237 stems are classified, one primary task each, no residue.

The twelve tasks, ranked

#	Task	Stems	Frameworks	Verbatim stem
1	Establish a diagnosis	62	26	”What is the periodontal diagnosis and the associated stage and grade?” (p.50)
2	Determine the most appropriate management / next step	50	21	”What is the most appropriate initial management for tooth ___?” (p.5)
3	Identify a radiographic or clinical finding	27	20	”What is the entity indicated by the arrow(s)?” (p.8)
4	Evaluate / critique technical work	26	24	”The preparation …”, “The die …” (pp.25, 27)
5	Select a procedure or treatment	26	16	”What is the most appropriate surgical procedure for tooth/teeth ___?” (p.55)
6	Determine prognosis	12	6	”Which factors compromise the prognosis of tooth ___ if it is restored with a crown?” (p.32)
7	Choose investigations / imaging	9	4	”What are the most appropriate investigations to confirm the diagnosis…?” (p.21)
8	Identify structure at risk / anticipate complication	9	4	”Which anatomical structures are most likely at risk to be damaged?” (p.83)
9	Recognize contributing / risk factors	8	3	”Which factors contribute to the periodontal condition?” (p.53)
10	Triage — decide referral threshold	4	1	”…whether this patient should be referred to a hospital?” (p.93)
11	Determine the cause of a failure	2	1	”What is the most likely reason for the treatment failure for tooth ___?” (p.7)
12	Recognize medical modifiers	2	2	”What special considerations are required for the management of this patient?” (p.98)

most appropriate appears in 74 stems across 35 frameworks — the default qualifier. Use it.

Two of the plan's expected verbs do not exist, and one whole family was missing

06-phase-3-pilot-periodontics.md §3.2 lists interpret and recognize contraindications. Both appear zero times. Restate them: interpret → identify the finding / establish the diagnosis; contraindications → the Avoid … answer-option family (21 option lines).

And “evaluate / critique technical work” is the second-largest framework family (24 of 102) — it drives Prosthodontics and Operative almost entirely, and the plan had no slot for it.

determine prognosis is also reframed: never “what is the prognosis”, always “which factors compromise the prognosis”. Prognosis is examined as factor-recognition, not as a grade.

How manage cashes out

Counts across all 2,167 answer options:

restore/replace 72 · treat 50 · extract 35 · remove 25 · no treatment / no management is required 22 · avoid 21 · obtain (labs, INR, HbA1c, imaging) 16 · place 14 · re-evaluate/reassess 13 · administer 13 · maintain 12 · adjust 11 · observe 9 · assess 9 · prescribe 6 · perform 6 · stop (medication) 5 · delay 4 · defer 3 · refer 2 · monitor 2 · medical consultation 2.

This is textual confirmation of the KSA document’s definition of manage: 22 option lines are an explicit do-nothing choice, and refer / defer / observe and re-evaluate / medical consultation are all live answers. An objective using “manage” that omits observation, deferral and referral has understated the tested scope.

Case template

Verbatim, p.2:

“For each question, information relevant to the case is provided and may consist of a case history, dental charts, photographs, radiographs, diagrams, videos, and/or 3D models. … Each framework may include more than one question. … The frameworks include lists of distractors of varying length. All answers/distractors may not appear on a given question.”

[optional lead-in: a plan already decided, or a data table]
STIMULUS: case history ± chart ± photo/radiograph ± diagram/video/3D model
DIRECTIVE: "Select ONE correct answer." and/or "Select ONE OR MORE correct answers."
STEM:      interrogative ("What is the most appropriate ___ for tooth ___?")
           OR declarative stem-completion ("The preparation …")
OPTIONS:   flat A–ZZ list, often including an explicit null option

Measured: mean 2.3 stems per stimulus, median 2, max 9. Option lists run min 3, median 20, max 52. 53 of 102 stimuli are asked both single- and multi-answer, so multi-answer is the majority mode — objectives must support “select all that apply”, not only “pick the best”.

Blanks are parameterised (tooth ___, [procedure], [type of crown]), so one framework generates many items. Lead-ins may pre-commit the plan (“Tooth __ is planned for extraction”) and ask you to judge its consequences.

Stimuli are standardised — pp.109–112 give the exact formats, each captioned “This is the sample included in the Virtual OSCE protocol”: case history (age/sex · chief complaint · history of chief complaint · dental · medical · medication · clinical findings), periodontal chart (furcation, recession, BOP, probing, mobility, vestibular and lingual), endodontic chart (probing, mobility, percussion, palpation, cold/heat/bite/EPT, discolouration), orthodontic chart (SNA, SNB, SN-MP, FH-MP, mean vs patient).

The Periodontics block — frameworks 45–56, pp.50–61

No discipline headings exist in the document; frameworks are numbered only. Periodontics is nonetheless unambiguous: twelve consecutive frameworks, 34 stems, the longest contiguous single-discipline block. Perio content also recurs as options in F2, F22, F71, F75.

FW	p.	Decision point
45	50	Diagnosis + stage + grade + extent, in one question
46	51	Diagnosis, per-tooth and per-implant
47	52	What data is still missing before a plan can be finalised
48	53	Contributing factors — periodontal and peri-implant
49	54	Phase I selection
50	55	Surgery addressing the chief complaint
51	56	Surgical procedure selection
52	57	Flap / incision design
53	58	Re-evaluation decision, from before/after charts
54	59	Next step after maintenance
55	60	Classification of recession
56	61	Site-level contributing factors, implant

Four things this dictates for KSA 26:

1. Diagnosis is compound, not a label. F45 asks diagnosis and stage and grade, with extent (localized / generalized / molar-incisor) in the same option list. One objective, four simultaneous judgements.
2. Perio and peri-implant run in parallel throughout. Five of the twelve duplicate every stem for implant ___. KSA 26’s Manage peri-implant diseases is examined at the same granularity as the natural dentition, not as an afterthought — despite being only Taught and Tested.
3. “Contributing factors” is a first-class question type, distinct from diagnosis — all 8 of the document’s factor-stems are perio. Write that shape, not “know the risk factors”.
4. Re-evaluation is a branching decision, not a procedure. F53/F54 give before/after charts and ask the candidate to choose between repeating non-surgical therapy, maintenance at a stated interval, surgery, or “No management and re-evaluate in 4-8 weeks.”

F47 has no KSA 26 counterpart

“What additional information is required to establish a diagnosis and finalize the treatment plan?” — the document treats what do I still need to know as a scored competency in Periodontics specifically. None of KSA 26’s five indicators covers it. Gap-report material.

What this document cannot tell you

The four NDEB levels are absent. Literal search over 112 pages: Taught 0, Experience 0, Competence/competenc* 0, KSA 0, blueprint 0. (Exposure has 6 hits, all clinical — “surgical tooth crown exposure”, “limiting radiation exposure” — none is the level.)

NDEB Level comes from the KSA document’s indicator tables (KSAs 24–31) and nowhere else. And do not infer weighting from framework counts — p.2 disclaims it: “The Virtual OSCE Frameworks do not represent the proportion of test items in the Virtual OSCE.”