Clinical examination performance in rural longitudinal medical programmes

Background and aims: Rural longitudinal medical programmes immerse students in rural communities for extended periods to help foster a rural-focussed medical workforce. There is limited evidence on how medical students undertaking the same curriculum across different geographic locations perform in Objective Structured Clinical Exams (OSCEs). We aimed to investigate if there were variations in OSCE performance between students at different sites of the Flinders University Doctor of Medicine Programme.

Methods: We retrospectively reviewed data from OSCEs undertaken by all third year graduate entry students at Flinders University in 2024. Quantitative data on overall performance, discipline- and domain-level performance were compared between students based in Metropolitan South Australia, Rural South Australia and the Flinders Northern Territory (NT) Medical Programme.

Results: Data from 172 students was included, with 102 (60%) from SA metropolitan areas, 33 (20%) from the SA rural stream and 37 (20%) from the NT rural stream. Overall OSCE performance was not different between training locations. Students from rural training locations performed better in communication (mean score 84% vs 67%, p < 0.001) than those from metropolitan sites. Variations in performance in Medicine, Acute Care and Primary Care disciplines were seen between locations (p < 0.001).

Conclusion: Medical students who underwent extended periods of training in rural locations performed similarly in standardised OSCEs compared to those from metropolitan locations. Variations in domain- and discipline-level performance were seen across locations, with rural students performing better in communication skills. Further research exploring the impact of diverse training exposures on OSCE performance is required.