Assessment of Clinical Competence: Implementation of the Objective Structured Clinical Examination (OSCE) in Saudi Medical Schools

Abstract

Assessment of clinical skills is essential in determining the competency of health professionals. The Objective Structured Clinical Examination (OSCE) is a performance assessment tool that is widely adopted for this purpose. Despite its widespread use in Saudi medical schools, the implementation and impact of the OSCE in Saudi Arabia (SA) have not been widely investigated. The aim of this research is to provide an in-depth understanding of OSCE usage in Saudi medical schools, the opportunities and challenges offered by its adoption, and to develop recommendations to improve implementation. Using a qualitative constructivist philosophy, this research employs a case study design in two different Saudi medical schools, integrating document review with interviews and focus groups with medical school leaders and their Faculty. Reflexive thematic analysis and codebook methods were applied to interviews/focus groups and documents, respectively. The analysis generated a series of key themes that impacted the OSCE implementation in Saudi medical schools. These themes constitute a conceptual framework that requires careful consideration in order for them to function harmoniously to produce a high-quality OSCE. This research also highlights that each stage of OSCE implementation in the investigated medical schools involves a series of dilemmas and compromises. Analysis suggests that funding sources (public or private schools), accreditation status, faculty experience, and resource availability all influence the quality of OSCE implementation. The research findings are consistent with the international OSCE literature; however, this work brings new insights into the use of the OSCE in SA, a non-western culture, and sheds light on the integrative nature of the factors that contribute to successful implementation. It concludes with a series of recommendations that individual medical schools and organisational networks can employ to improve the OSCE in SA, and beyond.