Students’ Perceptions of the Quality, Fairness, and Outcomes of the Objective Structured Clinical Examination (OSCE): A Cross-Sectional Study at Citycot University, Bosaso, Somalia

<ns5:p>Background The Objective Structured Clinical Examination (OSCE) is widely used to assess clinical competence, but evidence on students’ perceptions of its quality, fairness, and outcomes is limited in Somalia. This study assessed undergraduate health-science students’ perceptions of the OSCE at Citycot University, Bosaso. Methods An analytical cross-sectional study was conducted among 400 students enrolled in Nursing, Midwifery, Laboratory Science, Pharmacy, Nutrition, and Clinical Officer programmes. Data were collected using a structured, self-administered questionnaire covering seven domains: station quality, process and preparation, physical environment, perceived discrepancies, fairness and validity, examination stress, and OSCE outcomes and acceptance. Descriptive statistics, Cronbach’s alpha, Pearson correlation, and multivariable linear regression with robust standard errors were used. Results All 400 questionnaires were returned and included in the analysis. Overall OSCE outcomes and acceptance had the highest mean score (3.84 ± 1.13), followed by fairness and validity (3.76 ± 1.05), process and preparation (3.64 ± 1.06), physical environment (3.63 ± 1.04), and station quality (3.47 ± 0.97). Examination stress was moderate (3.21 ± 1.22), while perceived discrepancies had the lowest mean score (2.72 ± 1.07). Cronbach’s alpha ranged from 0.69 to 0.85. The process and preparation domain was strongly correlated with fairness and validity (r = 0.72), while OSCE outcomes were correlated with both process and preparation and fairness and validity (r = 0.69 for each). Prior OSCE exposure was associated with higher examination stress. Conclusion Students generally perceived the OSCE as a fair and acceptable method of clinical assessment. Improving preparation, station quality, examination conditions, and psychological support may enhance students’ OSCE experiences and perceived outcomes.</ns5:p>