Association Between Structured Obstetric Simulation and OSCE Performance in Undergraduate Medical Students

Clinical simulation is widely used to develop practical skills in undergraduate medical education. In obstetrics, it enables students to practice complex clinical scenarios; however, evidence regarding its association with objective assessments, such as the Objective Structured Clinical Examination (OSCE), remains limited.

A retrospective cross-sectional study was conducted among 71 fifth-year medical students who completed the 2023 OSCE. Performance in the labor and delivery station was evaluated using a standardized 17-item checklist developed by the institutional OSCE committee and applied by trained evaluators. The main exposure variable was prior participation in obstetric simulation sessions. Sociodemographic and academic variables were collected through a post-examination questionnaire. Welch's t-tests and multivariable linear regression with Huber-White robust standard errors were used to analyze the association between simulation exposure and OSCE performance, adjusting for cumulative GPA.

Students who participated in obstetric simulation scored significantly higher in the delivery station (M = 77.6, SD = 15.8) compared with those who did not (M = 43.4, SD = 22.5) (p < 0.001), corresponding to a very large effect size (Hedges' g = 1.68). In the adjusted multivariable model (adjusted R² = 0.441), absence of simulation was associated with a 22.23-point decrease in performance (95% CI: -36.8 to - 7.7; p = 0.0037), independent of cumulative GPA.

Participation in structured obstetric delivery simulation was independently associated with higher performance in a standardized OSCE station. These findings support the role of simulation as a complementary strategy in undergraduate obstetrics training and suggest meaningful transfer of learning to objective clinical assessment contexts.