Medical Students’ Perception of a Newly Implemented Objective Structured Clinical Examination (OSCE) in Orthopedic Surgery and Trauma: A Mixed-Method Study

Introduction: Objective Structured Clinical Examination (OSCE) is a well-known, widespread method of assessment of clinical skills. It is being widely used in Egyptian medical schools. This study aimed to explore the perception of the fifth-year medical students on the attributes, quality, validity, reliability and organization of the end-of-rotation Orthopedics Surgery and Trauma OSCE held at FOM-SCU in two academic years (2017-2018 and 2018-2019). It also aimed to assess the students rating of OSCE in relation to the other available assessment methods in clinical rotations. Material and Methods: This is a cross-sectional mixed-method study that was conducted at Suez Canal University Hospital. A convenient sample of the fifth-year medical students, who underwent the OSCE at the end of their Orthopedic Surgery and Trauma rotation during both academic years 2017-2018 and 2018-2019 were involved (n = 254). Quantitative data were collected through a validated questionnaire consisting of 32 items. Focus group discussions of students were conducted and qualitative data were recorded, coded, and thematically analyzed. Results: More than half of the students (55.5%) believed that the exam was fair and covered a wide range of knowledge (63.8%) and clinical skills (72.4%). Considerable percentages of students were doubtful regarding the standardization of OSCE scores (62.6%) and whether those scores provided a true measurement of their clinical skills (65%) and more than half of them were not sure whether gender, personality, or ethnicity affected their exam scores (55.5%) and whether OSCE provides them practical and useful experience (53.5%). OSCE and portfolio were reported as the easiest method among 55.5% and 63.8% of students, respectively, and 31.1% rated MCQs as the most difficult form of assessment. Qualitative analysis identified two themes; namely: “Challenges of implementing OSCE” and “Ways to overcome identified challenges”. Conclusion: Medical students positively perceived and provided good perception on the organization and implementation of the Orthopedics OSCE, although some of them were doubtful regarding its validity and reliability in assessing their clinical skills in Orthopedics and Trauma. The challenges regarding the OSCE can be overcome by more well-structured, practical training and orientation sessions for the examiners, students, and simulated patients.