Effectiveness of formative OSCE-based training for sixth-year medical students on the diagnostic strategy for rheumatoid arthritis: a randomized controlled trial

The objective structured clinical examination (OSCE) is widely used internationally as an effective method for both formative learning and assessment; however, its integration into undergraduate medical curricula remains variable across settings. The aim of this study was to evaluate the effectiveness of OSCE-based training in enhancing knowledge and skills for the diagnostic strategy for rheumatoid arthritis (RA) among medical students. This single-blind randomized controlled trial involved sixth-year medical students at the Faculty of Medicine in Rabat. All participants received the same preparatory teaching material on RA one week prior to the trial. On the first day, the participants completed a pretraining multiple-choice questionnaire (MCQ) on RA diagnostic strategy and were then randomized into two groups: an intervention group receiving formative OSCE-based training on RA diagnostic strategy ( n = 30) and a control group receiving traditional training through lectures and clinical case studies ( n = 30). On the second day, students' clinical performance was evaluated via a summative OSCE and a post-training MCQ, supplemented by a self-satisfaction questionnaire. Summative OSCE scores were compared between the two groups. Post-training MCQ scores and changes from pre- to post-training were compared between groups. Compared with the control group, the OSCE-trained group achieved a significantly higher score on the summative OSCE (95% CI: 1.87–3.92; p < 0.01). However, no significant difference in post-training MCQ scores was observed between groups ( p = 0.23). The formative OSCE improved subsequent performance on the summative OSCE for RA diagnosis. These findings support the broader implementation of skill-based educational approaches, such as OSCEs, in medical curricula to enhance clinical competencies. Pan African Clinical Trials Registry (PACTR). Registration number: PACTR202505840416202. Date of registration: 15 May 2025.