# Validating simulated patient programmes in Obstetrics and Gynaecology education: a mixed-method study on training effectiveness and stakeholder perceptions in the GCC

## TL;DR

This study validates the use of trained simulated patients in OB-GYN education in GCC countries, showing effectiveness and identifying cultural and logistical challenges.

## Contribution

The study provides insights into training simulated patients for OB-GYN education in culturally sensitive GCC contexts and offers recommendations for improvement.

## Key findings

- Structured training of simulated patients showed moderate-to-high inter-rater reliability in OB-GYN history-taking assessments.
- Stakeholders reported enhanced student engagement, realism, and communication skills through SP use.
- Cultural sensitivities, SP diversity, and logistical issues were identified as key challenges in SP program implementation.

## Abstract

Simulated patients (SPs) are widely used in medical education to help students acquire clinical skills in a safe and realistic setting. In fields such as obstetrics and gynaecology (OB-GYN), where real-patient interactions can be limited due to cultural sensitivities—especially in Gulf Cooperation Council (GCC) countries—SPs play a crucial role in medical education. This study aimed to validate the training of SPs for assessing OB-GYN history-taking skills and explore the perceptions of stakeholders – including faculty, students, leadership and SPs – regarding the implementation, challenges and potential improvements of the SP programme.

A mixed-methods research design was employed in this study. During the quantitative phase, training of SPs using a structured OB-GYN history-taking module was conducted, followed by an evaluation of their performance by expert raters. The inter-rater reliability was assessed using Fleiss’ Kappa and Cronbach’s alpha. In the qualitative phase, semi-structured interviews and focus groups were conducted with students, SPs, faculty trainers and academic leaders. Thematic analysis was performed to identify common themes and divergent viewpoints.

Quantitative results showed moderate-to-high inter-rater reliability, indicating consistent and effective SP performance post-training. Qualitative findings revealed that stakeholders perceived that the usage of SPs results in the enhancement of student engagement, realism and communication skills. However, challenges such as cultural sensitivities, limited SP diversity and logistical constraints were highlighted. Stakeholders emphasised the need for culturally contextualised training, periodic feedback loops and institutional support.

The study confirms that structured training can effectively prepare simulated patients for OB-GYN education in GCC settings. By integrating stakeholder feedback, this study provides valuable insights for refining SP programmes and addressing region-specific challenges. A more culturally aware and well-supported SP programme can boost student confidence and improve learning outcomes in sensitive clinical areas like OB-GYN.

The online version contains supplementary material available at 10.1186/s12909-025-07912-2.