The issuance of the World War I Victory Medal established another precedent, that of wearing clasps with the names of individual battles on the suspension ribbon of a general campaign medal. This was an ongoing practice in many countries, most notably Britain and France, since the 19th Century. When the ribbon bar alone was worn, each clasp was represented by a small (3/16" diameter) bronze star. Fourteen such clasps were adopted along with five clasps to denote service in specific countries. However, the latter were issued only if no campaign clasp was earned. Only one service clasp could be issued to any individual and they were not represented by a small bronze star on the ribbon bar. It is a final irony that the British, who were the greatest proponents of the practice, never issued a single bar with their own version of the Victory Medal.
During this period, the Army introduced the Citation Star which was established by Congress on July 9, 1918. This award, a 3/16 inch diameter silver star device, was originally authorized to be worn on the World War I Victory Medal to denote those who had been cited for extreme heroism or valor. The device, which evolved into the Silver Star Medal in 1932, was soon made retroactive as an attachment to the Army service medals for the Civil War, Indian, Spanish, China and Mexican Campaigns. Although the Citation Star was strictly a U.S. Army device, an identical ribbon attachment designated the Navy Commendation Star, was authorized for wear on the World War I Victory Medal by Navy and Marine Corps personnel who had received a Letter of Commendation from the Secretary of the Navy. However, the two awards were not considered equivalent and the Navy version was not upgradable in subsequent years to the Silver Star Medal. Bronze oak leaf clusters were also introduced to indicate a second award of the Medal of Honor or other decoration in lieu of a second medal.