Stakeholder perspectives on the Emirati board comprehensive clinical examination: a mixed-methods multi-stakeholder evaluation

High-stakes clinical examinations play a critical role in postgraduate medical training by assessing readiness for independent specialist practice. While hybrid Objective Structured Clinical Examination (OSCE)-style assessments are increasingly used to evaluate integrated clinical competence, evidence incorporating the perspectives of multiple stakeholders remains limited, particularly in large-scale specialist certification examinations. Multi-stakeholder evaluations may provide valuable insights into examination quality, implementation, and stakeholder experience.

To evaluate stakeholder perceptions of the Emirati Board Comprehensive Clinical Examination (CCE) across key domains, including orientation, logistics, educational value, task clarity, examiner behaviour, and overall examination experience, and to identify implementation factors that may influence perceived examination quality.

A convergent mixed-methods study was conducted using repeated cross-sectional stakeholder feedback collected across multiple CCE examination sittings between November 2024 and January 2026. Quantitative data were obtained from post-examination surveys completed by examinees (n = 368), examiners (n = 390), and quality assessors (QA; n = 88), supplemented by post-examination debriefing notes from all stakeholders. Quantitative data were analysed using descriptive statistics and group comparisons, while qualitative data underwent thematic analysis. Findings from both data strands were integrated during interpretation.

Examiners and quality assessors reported consistently positive perceptions of the examination (mean scores 4.4-4.8 out of 5), whereas examinees reported more moderate ratings (overall mean 3.88 out of 5), particularly regarding orientation, logistics, and task clarity. Qualitative findings complemented these results by identifying perceived variability in task instructions, time allocation, examiner interactions, and simulated patient performance. Integration of quantitative and qualitative findings indicated broad agreement regarding the educational value and overall organization of the examination, while also highlighting differences between system-level evaluations and examinees' lived experiences.

The Emirati Board CCE was generally perceived as a well-organized and educationally valuable assessment by all stakeholder groups. However, examinees reported greater variability in their examination experience than examiners and quality assessors, particularly in domains related to orientation, logistics, and task clarity. These findings suggest that enhancing consistency in examination implementation may improve stakeholder experience, perceived fairness, and future quality improvement initiatives in high-stakes clinical assessment.