# Evaluation of the implementation of the objective structured clinical examination in health sciences education from a low‐income context in Tunisia: A cross‐sectional study

## TL;DR

This study evaluates how well OSCEs work in a low-income health sciences school in Tunisia, showing they are effective and well-received.

## Contribution

The study provides evidence for the successful implementation of OSCEs in a low-income context, highlighting their efficacy compared to traditional exams.

## Key findings

- Health sciences educators showed high satisfaction with OSCEs, while students had above-average satisfaction.
- Students performed better in OSCEs compared to traditional practical examinations.
- Significant differences in satisfaction and performance were found based on students' specialities.

## Abstract

Objective structured clinical examination (OSCE) is well‐established and designed to evaluate students' clinical competence and practical skills in a standardized and objective manner. While OSCEs are widespread in higher‐income countries, their implementation in low‐resource settings presents unique challenges that warrant further investigation.

This study aims to evaluate the perception of the health sciences students and their educators regarding deploying OSCEs within the School of Health Sciences and Techniques of Sousse (SHSTS) in Tunisia and their efficacity in healthcare education compared to traditional practical examination methods.

This cross‐sectional study was conducted in June 2022, focusing on final‐year Health Sciences students at the SHSTS in Tunisia. The study participants were students and their educators involved in the OSCEs from June 6th to June 11th, 2022. Anonymous paper‐based 5‐point Likert scale satisfaction surveys were distributed to the students and their educators, with a separate set of questions for each. Spearman, Mann–Whitney U and Krusakll–Wallis tests were utilized to test the differences in satisfaction with the OSCEs among the students and educators. The Wilcoxon Rank test was utilized to examine the differences in students' assessment scores in the OSCEs and the traditional practical examination methods.

The satisfaction scores were high among health sciences educators and above average for students, with means of 3.82 ± 1.29 and 3.15 ± 0.56, respectively. The bivariate and multivariate analyzes indicated a significant difference in the satisfaction between the students' specialities. Further, a significant difference in their assessment scores distribution in the practical examinations and OSCEs was also demonstrated, with better performance in the OSCEs.

Our study provides evidence of the relatively high level of satisfaction with the OSCEs and better performance compared to the traditional practical examinations. These findings advocate for the efficacy of OSCEs in low‐income countries and the need to sustain them.