Manchester Medical School is the largest medical school in the UK, with over 2000 students on the MBChB programme. During the final three years of the programme all students undergo regular assessments of their clinical skills through a series of Objective Structured Clinical Examinations (OSCEs). The OSCEs require students to carry out a series of simulated exercises in front of an examiner. The examiner completes a score-sheet for each student, giving a mark between 1 and 7 for each of four criteria together with a 'global mark', again between 1 and 7. The examiner also leaves a small piece of written feedback on the bottom of each form. Following the exam, all the score-sheets from each of the four teaching hospitals attached to the University are scanned using an optical reader. This involves a large amount of effort and provides many opportunities for errors. Due to the work involved and logistical problems, student feedback from the OSCEs is currently limited to a single mark. Despite the examiners providing the piece of text on the score-sheet, this is only made available to students scoring less than 4 on their global mark. The students and the School are increasingly motivated to allow all students access to the written feedback. Hence, in an effort to increase efficiency of the OSCE process and enable the delivery of student feedback, the Medical School has piloted the use of digital pens as a method of capturing and processing scoring and feedback. This case study presents the process and evaluation of the pilot. The study examines the choice of technology, the aims of the pilot and an evaluation of the technology to assess whether objectives have been achieved. An impact analysis of the use of the pens over a five year period also shows the return on investment.