Summary.An emergency medicine and trauma programme was implemented at Ben Gurion University Medical School in Israel. Clinical performance assessment of the first‐year course in emergency medicine and trauma was done using a practical examination (PE). In the continuous process of critically reviewing the course objectives and assessment methods the objective structured clinical examination (OSCE) was chosen, for the first time in our medical school, as a tool for course development as well as evaluation of the existing PE. Seven experimental OSCE stations were designed which covered some of the course and practical examination topics. Twenty‐six first‐year medical students have taken both examinations concurrently. Twenty‐three students answered an attitude questionnaire regarding both examinations. Results have indicated that the OSCE provided additional and crucial information on students' deficiencies in clinical performance which were not available from the PE. Those differences were probably due to realistic OSCE station content, highly simulated set‐ups, and the objectivity of the examiner, all of which have contributed to a more challenging examination, as compared to the PE. The OSCE in emergency medicine and trauma seemed to have a relatively high level of acceptance by both staff and students. In our opinion it seems that the OSCE is a better tool for first‐year level final assessment in emergency medicine