Khaled Almisnid¹
Matt Homer², Trudie Roberts³ and Rikki Goddard-Fuller⁴
1 Medical Education Unit, Unaizah College of Medicine, Qassim University, KSA.
2 Leeds Institute of Medical Education, School of Medicine, University of Leeds, UK 
3 Emeritus Professor of Medical Education, University of Leeds, UK
4 Christie Education, Manchester, UK 

Background

The Objective Structured Clinical Examination (OSCE) is a valuable performance assessment tool widely adopted in medical schools. Despite its significance and widespread use, the literature indicates that many medical schools worldwide struggle to implement effective OSCEs. 

This study triangulated data from four sources to generate a comprehensive overview of the processes and procedures required to implement a successful OSCE in a Saudi undergraduate setting: a scoping literature review exploring OSCE implementation across disciplines and regional contexts, documentary analysis, interviews with academic leaders, and focus groups involving clinical teachers who use the OSCE in their practice. 

The analysis adopted a three-stage model for designing the OSCE, encompassing pre-OSCE, peri-OSCE, and post-OSCE processes. Alongside the multiple steps within each of these stages, three key influential factors played a crucial role in each step, including the institutional environment, staff expertise, and the availability of resources and infrastructure. Thoughtful consideration and establishment of these factors are essential to implement each stage effectively. 

The integration of empirical research aligns the findings with the existing key literature and enriches and contextualises them. This approach offers a more comprehensive and nuanced understanding of OSCE implementation dynamics and their practical implications for emerging medical schools. 

Institutions should be aware of the extensive time and effort necessary to implement an effective OSCE. Therefore, this study proposes a model to facilitate this pursuit. Furthermore, it underlines that the Western literature/model could have some limitations in developing effective OSCEs in other contexts, stressing the need for contextually relevant practice models. 

Although the OSCE is a complex assessment tool, when used properly, it can produce results that meet the criteria for good assessment. However, this study suggests that OSCE implementation is context-dependent, highlighting the need for future research on contextual factors and OSCE implementation. 

References (maximum three) 

Bearman, M., Ajjawi, R., Bennett, S. and Boud, D. 2020. The hidden labours of designing the Objective Structured Clinical Examination: a Practice Theory study. Advances in Health Sciences Education. 26, pp.637-651. 

Harden, Lilley, P. and Patricio, M. 2015. The Definitive Guide to the OSCE: The Objective Structured Clinical Examination as a performance assessment. 1 ed. Edinburgh: Elsevier. 

Hodges, B. 2003. Validity and the OSCE. Medical Teacher. 25(3), pp.250-255.