Implementation of objective structured clinical examination among midwifery and nursing educators at South and Central Region Universities in Ethiopia, 2023

Zerihun Demessie Dilebo, Bekana Fekecha Hurissa and Kebenesa Angasu Kitaba

PLOS ONE, 2026, vol. 21, issue 8, 1-17

Abstract: Introduction: The Objective Structured Clinical Examination (OSCE) is a well-known clinical skill evaluation tool that has been applied worldwide to teach and assess learners’ competencies in healthcare disciplines. Poor implementation of OSCE can lead to inaccurate assessments and ultimately result in the production of incompetent professionals. However, there is no evidence of the implementation status and factors that limit the much-needed OSCE practice in the study area. Objective: To assess OSCE implementation among midwifery and nursing educators in the South and Central region of Ethiopian universities, 2023. Methods: An institution-based cross-sectional study with a mixed approach was used among 269 midwifery and nursing educators and 15 key informants from 8 May to 10 June 2023. All midwifery and nursing educators were included from randomly selected 4 universities in southern and central Ethiopia. Quantitative data were collected using pretested self-administered questionnaires and were analyzed using descriptive statistics and logistic regression. With a p-value of less than 0.05, which denotes statistical significance, a corresponding 95% confidence interval (CI) was calculated. Qualitative data was collected through in-depth interviews and analyzed using open-code software Version 4.02, and findings were used to support quantitative findings. Results: A total of 260 (97%) educators participated in this study, and 43.5% (95% CI 37.4–49.5) of them had a good OSCE implementation. Training in OSCE (AOR = 2.07, 95% CI 1.03–4.17), having an OSCE checklist (AOR = 1.89, 95% CI 1.05–3.42), having equipment (AOR = 2.36, 95% CI 1.03–5.39) and negative perceptions toward OSCE (AOR = 0.53, 95% CI 0.31–0.92) were significantly associated, and poor organization and planning, perceptions towards OSCE, shortage of resources and insufficient number and duration of the station were found by qualitative study. Conclusions: Less than half of educators have had a good OSCE implementation. Training, equipment, checklists, and perceptions highlight issues such as poor organization and planning, resource, and time allocation stations found as influencing factors. In addition to improving in-service and ongoing OSCE training, it is preferable to ensure the availability and accessibility of resources in the facilities to improve OSCE implementation.

Date: 2026
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DOI: 10.1371/journal.pone.0356551

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