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Rationale: The OSCE has become one of the most important assessment methods of health professionals’ communication. Although the format has been used for almost forty years, there are still unsolved questions. This symposium will enable five key challenges to be explored from a variety of perspectives. Presentations: Each presentation will address a selection of the following: 1) Should communication skills be assessed together with other clinical skills or separately? 2) Are detailed checklists better than global ratings? 3) What is the role of feedback? 4) What is adequate in examiner training? 5) Is the money spent worth the effort and impact on students’ learning? Presentation 1: Jonathan Silverman; University of Cambridge School of Clinical Medicine; Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0SP;   js355@medschl.cam.ac.uk The Simulated Clinical Encounter Examination is a high stakes finals 10‐station 100 minute OSCE which integrates content, process and clinical reasoning in simulated patient encounters. Experiences with integration, rating scales and particularly major issues with feedback will be highlighted. Comparisons will be made with other UK OSCEs visited as an external examiner to demonstrate the importance of station and circuit design and length Presentation 2: Marc van Nuland; Department of General Practice, University of Leuven, Belgium; marc.vannuland@med.kuleuven.be The 10‐station communication skills OSCE is a high stakes final exam in the 4th master for students having chosen to start General Practice vocational training. Experiences with global versus checklist rating scales, provision of narrative feedback and cost issues related to this OSCE will be discussed in the light of optimizing the utility of the OSCE. Presentation 3: Sabine Feller; Institute of Medial Education, University of Bern, Faculty of Medicine; Konsumstrasse 13, CH‐3010 Bern;   sabine.feller@iml.unibe.ch The Swiss national licencing exam for candidates entering postgraduate training is a 12‐station OSCE which integrates clinical and communication skills in simulated patient encounters. Experiences with assessment of communication skills together with other clinical skills, with generic rating scales, length of examiner training and the impact on students' learning will be presented. Presentation 4: Claudia Kiessling, Institute for Medical Education, University of Munich; Ziemssenstr. 1; D‐80336 München, Germany; claudia.kiessling@med.uni‐muenchen.de A cross‐sectional online‐survey investigated the use of different assessment methods for communication skills in undergraduate medical education in Germany, Austria, and Switzerland. Results indicate that OSCEs are widely used. Approaches concerning the separation or integration with clinical skills, average number of stations, use of rating schemes, and different outlines of examiner trainings will be presented.