Purpose: To develop two new types of clinical feedback for final year medical students using OSCE mark sheets and to evaluate their effectiveness, cost-effectiveness and student satisfaction in a randomized trial. Methods: A randomized trial was conducted with two groups (Cohort A and B) of students (n = 350) at the University of Birmingham (UK) participating in a two stage Objective Structured Clinical Examination (OSCE) (November 2011 and April 2012). Students were randomly assigned to receive one of three feedback interventions (skills-based, station-based, or both) after the November OSCE. Multivariate regression analysis was used to test if feedback intervention was a significant predictor of April OSCE score, while controlling for November OSCE score. Secondary outcomes were cost-effectiveness and student satisfaction. Results: Feedback group was not a significant predictor of April scores for Cohort B. In Cohort A, the station-based group did better than the group who received both types of feedback (2.8%, 95% CI 0.4% to 5.2%, p = 0.022). There was no difference between the skills-based and station-based groups. The cost of providing the station-based feedback was double of that for the skills-based. Questionnaires were received from 245 students (70%). Students who received both types of feedback were the most satisfied, followed by those in the station-based group. Conclusion: There was no consistent difference in effectiveness across the three trial groups. Students tended to prefer station-based feedback over skills-based feedback, but students found elements of the standard feedback more helpful than the feedback evaluated in this trial.