Purpose: The main purpose of this study is to introduce the developmental process of the 'Objective Structured Clinical Examination' (OSCE) in the field of occupational therapy (OT), whilst also investigating whether OSCE is of use in helping students to acquire important clinical skills. Methods: The four skills of 'group leadership', 'case management', 'assessment' and 'interview/ therapeutic relationships' developed in this study were based upon focus groups and a review of the extant literature. We created case scenarios for each of these four skills, developed the ratings checklists for use by both the examiner and standardized patients (SP) and then derived a questionnaire to study the feasibility of the OSCE. Undergraduate OT students were invited to join the pilot study, which results in thirteen students consenting to participate (mean age 21.3 ± 0.95 years, 31 per cent male). The study was approved by the Institutional Review Board of the National Taiwan University (NTU-REC No: 201202HS0001). Results: Four skills modules were created for the OSCE, with the number of items on the checklist for these four skills varying from 5 to 22; the ‘interrater reliability’ (ICC) for the four skills ranged between 0.71 and 0.77, whilst the pass rate for the skills ranged between 0.07 and 0.77. The responses to the feedback questionnaire showed that 85 per cent of the students felt that the OSCE was appropriate, 92 per cent felt that it was similar to the real-world situation and all of the students agreed that the OSCE testing reflected their actual clinical abilities. Conclusions: Our findings provide support for the feasibility of the application of the OSCE in OT education. The low pass rate achieved by the students may simply be attributable to the lack of training and explanation to the students of the OSCE procedure.