Assessment of clinical competence of graduating medical students in Ethiopia

Abstract

Background: Ethiopia scaled up medical education to improve access to healthcare which presented challenges in maintaining training quality. We conducted a study aiming to assess the clinical competence of graduating medical students and the associated factors. Methods and materials: A pretest assessment of a quasi-experimental study was conducted in 10 medical schools with a sample size of 240 students. We randomly selected 24 students per school. Clinical competence was assessed in a 12-station OSCE. The clinical learning environment (CLE), simulation training, and practice exposure were self-rated. Using the SPSS v. 27, mean scores for clinical competence, and satisfaction on CLE and simulation training were calculated. Proportions of students with practice exposure, and who agreed on CLE and simulation items were done. Independent test tests were used to see competence differences among subgroups. Bivariate and multiple linear regression models were fitted for the outcome variable: competence score. A 95% statistical confidence interval and p-value < 0.05 were used for making statistical decisions. Results: The mean clinical competence score was 72%. Students scored lower in performing MVA (62 %), LP (64%), and childbirth (66%) tasks. Female students (73%) were had significantly higher score than males (70%). Higher CGPA, positive appraisal of CLE, and conducting more procedures were associated with competence development. Only a little more than 50% of the participants were satisfied with the number of students during practice sessions and the assessment in clinical teaching. About two-thirds of the respondents were not satisfied with the sufficiency of models and equipment, and the provision of feedback. More than one-tenth of them never performed LP, MVA, normal delivery, and venipuncture procedures. Conclusions Medical students had an acceptable clinical competence. Better CLE, CGPA, and practice exposure are associated with higher scores. Strengthening clinical practice and simulation training is needed at schools. CPD and mentoring should be considered to fill the skills gaps of the new graduates.