Published: 2021-11-24

Factors influencing Bachelor of Science in Clinical Medicine students performance in Clinical Officer Council Licensure examination, Kenya

Eunice M. Kuria, Margaret W. Nyongesa, Joseph K. Choge, Norbert Boruett


Background: Clinical medicine program has recorded high rates of student’s enrolment to training while their performance in clinical officers’ council (COC) licensure examination remains variable. This study investigated performance of clinical medicine degree student’s in COC examinations by determining student characteristics, institutional and regulatory body factors in relation to performance.

Methods: A retrospective study, using mixed method approach to collect data. A sample total of 427 of students was analyzed while cluster and purposive sampling were used for key informants interviewed. Quantitative data was converted from Microsoft excel to statistical package for the social sciences (SPSS) software version 26 and analysed. Odd ratio was used to measure strength of association between students,institutions and regulatoy body charateristics and performance with p<0.05 being considered significant. Qualitative data was transcribed  for content analysis.

Results: The results indicated that there was highly significant relationship among the performance of students in government and private institutions respectively (p<0.001) unlike faith-based institutions (p=0.292). Private institutions were 0.158 more likely to perform better than other institutions while government institutions were 5 times more likely to perform better than any other institutions.

Conclusions: Age, mode of study and years of experience were found to be significant factors associated with performance while intergrity in marking was an important concern. The recommendations from the study are that training institutions continue upgrading program but factors contributing to low performances should be looked into. There is need to select experienced faculty to teach and set competency based licensure examination after internship.The study has demonstrated that results can be used to predict performance which are reliable for developing recruitment and examination policies.


Clinical medicine, Admission characteristics, Clinical performance, Academic performance

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Marie M. Clinical officers improve health care in Kenya. Clinical Advisor. Clin Advis. 2017;14(1):65-69.

Hooker RS, Kuilman L. Physician Assistant Education: Five Countries. J Physician Assist Educ. 2011;22(1).

Hooker RS, Everett CM. The contributions of physician assistants in primary care systems. Heal Soc Care Community. 2012;20(1):20-31.

Couper I, Ray S, Blaauw D. Curriculum and training needs of mid-level health workers in Africa: A situational review from Kenya, Nigeria, South Africa and Uganda. BMC Health Serv Res. 2018;18(1):1-12.

Eyal N, Cancedda C, Kyamanywa P, Hurst SA. Non-Physician clinicians in Sub-Saharan Africa and the evolving role of physicians. Int J Heal Policy Manag. 2016;5(3):149-53.

Mullan F, Frehywot S. Non-physician clinicians in 47 sub-Saharan African countries. Lancet. 2007;370(9605):2158-63.

Momanyi GO, Adoyo MA, Mwangi EM, Mokua DO. Value of training on motivation among health workers in Narok county, Kenya. Pan Afr Med J. 2016;23:1-12.

Clinical Officers Council. Examination Policy Guidelines First Edition. Gov Kenya. 2016;256(9):1-47.

Kumwenda B, Cleland JA, Walker K, Lee AJ, Greatrix R. The relationship between school type and academic performance at medical school: A national, multi-cohort study. BMJ Open. 2017;7(8):1-12.

Edward MI. Relationship between School Quality and Students’ Performance in Selected Schools of Nursing in South-Western Nigeria. IOSR J Nurs Heal Sci. 2013;3(1):37-46.

Shachar M, Yoram N. Differences Between Traditional and Distance Education Academic Performances: A meta- analytic. Bull la Société d’histoire Nat Toulouse. 2003;92(2):100-4.

Obwoge RO. Medical Students’ KCSE Grade and Their Relationship to Academic Performance: A Case of Egerton and Moi Universities, Kenya. Sci J Educ. 2017;5(2):34.

Idowu OO. An Investigation of Mathematics Performance of High School Students in Lagos state, Nigeria: External Factors. Urban Educ Res Policy Annu. 2016;4(1):178-88.

Darling-Hammond L. Assessing Teacher Education: The Usefulness of Multiple Measures for Assessing Program Outcomes. J Teach Educ. 2006;57(2):120-38.

WHO. International Classification of Health Workers—Definitive Guide. Gregory Schmidt. World Heal Organ. 2010;154(85):659-736.

Låg T, Sæle RG. Does the Flipped Classroom Improve Student Learning and Satisfaction? A Systematic Review and Meta-Analysis. AERA Open. 2019;5(3):233285841987048.

Rawlani S, Rawlani S, Lohe V, Bhowate R, Khubchandani M, Chandak R. Perception of dental faculty and student regarding class attendance and final performance. J Educ Health Promot. 2018;7(1):153.