Aim: The Objective Structured Clinical Examination (OSCE) is a gold-standard assessment in health professions education. We aimed to evaluate evidence on preparation strategies and techniques that enhance OSCE performance, confidence, and reduce anxiety.

Methods: We searched PubMed, Scopus, Embase, Cochrane, and ERIC for studies involving medical, nursing, and allied health students. Eligibility criteria included interventions focused on OSCE preparation, with outcomes measuring performance, confidence, or stress. The review followed PRISMA guidelines, and the risk of bias was assessed for included studies.

Results: Ten studies (n=1,045 participants) were included. Key effective strategies identified were simulation-based training, peer-assisted learning, video-assisted reflection, anxiety coping programs, and OSCE-focused podcasts. Quantitative outcomes showed significant improvements in OSCE scores (e.g., +3.5 points, p=0.03), confidence (gains of +18 to +31 points), and anxiety reduction (-11.61 units, p<0.001). However, evidence was characterized by heterogeneity in design and a reliance on self-reported data.

Conclusions: Multimodal preparation strategies consistently improve OSCE readiness. The most effective techniques integrate performance rehearsal with psychological support. Significant heterogeneity in current evidence underscores the need for standardized, validated OSCE preparation protocols to guide educational practice.

Keywords: Clinical competence, Medical education, Objective Structured Clinical Examination, Preparation strategies, Simulation.