Perceptions of postgraduate trainees on the impact of objective structured clinical examinations on their study behavior and clinical practice

Robert O Opoka,1 Sarah Kiguli,1 Andrew S Ssemata,2 Marjan Govaerts,3 Erik W Driessen3 1Department of Paediatrics and Child Health, 2Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda; 3Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands Background: The objective structured clinical examination (OSCE) is a commonly used method of assessing clinical competence at various levels, including at the postgraduate level. How the OSCE impacts on learning in higher education is poorly described. In this study, we evaluated the perceptions of postgraduate trainees regarding the impact of the OSCE on their study and clinical behavior. Methods: We employed an explorative qualitative research design by conducting focus group discussions with 41 pediatric postgraduate trainees at the College of Health Science, Makerere University. A semi-structured tool was used to obtain the views and experiences of the trainees. Transcripts from the discussion were analyzed in an iterative manner using thematic content analysis. Results: The trainees reported the OSCEs as a fair and appropriate tool for assessing clinical competency at the postgraduate level. However, they noted that whereas OSCEs assess a broad range of skills and competencies relevant to their training, there were areas that they did not adequately assess. In particular, OSCEs did not adequately assess in-depth clinical knowledge or detailed history-taking skills. Overall, the majority of the trainees reported that the OSCEs inspired them to study widely and improve their procedural and communication skills. Conclusion: OSCEs are a useful tool for assessing clinical competencies in postgraduate education. However, the perceived limitations in their ability to assess complex skills raises concerns about their use as a standalone mode of assessment at the postgraduate level. Future studies should evaluate how use of OSCEs in combination with other assessment tools impacts on learning. Keywords: objective structured clinical examination, assessment, higher education, perceptions, clinical practice, study, learning behavior