Factors associated with retakes in health professions courses: a case study of five selected universities in Sub-Saharan Africa

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Abstract Background Academic examination retakes are significant challenges in health professions education. With rigorous clinical assessments, limited training resources and high-stakes examinations, students struggle to meet academic requirements which cab result in retakes. This study aimed to assess the proportion of medical and nursing students with retakes across five Sub-Saharan African universities and to explore factors contributing to the retakes. Methods This was a cross-sectional quantitative study. The study involved 764 medical and nursing clinical students from five universities across Sub Saharan Africa: Busitema University (Uganda), Mzuzu University (Malawi), University of Ibadan (Nigeria), Kwame Nkrumah University of Science and Technology (Ghana), and the University of Zambia. Data was analyzed using descriptive statistics and logistic regression to identify factors associated with retakes. Results Overall, the proportion of students who had ever had a retake in clinical assessments was 12.6%. Factors associated with retakes are age with students aged 25 and above showed a higher likelihood of failing compared to their younger counterparts (OR: 2.45, 95% CI: 1.06–5.64, P = 0.036) and gender with Male students more likely to get retakes compared to their female counterparts (OR: 1.91, 95% CI: 1.21–3.00, P = 0.005) at univariate, although this association was not statistically significant in multivariate analysis. OSCE was the most frequent examination format associated with retakes, accounting for 47.7% ( P < 0.001). Conclusions The present study brings to light the proportion of students who experienced retakes and the factors associated with retakes among health professions students in Sub-Saharan Africa. This highlights the need for institutional interventions targeting at-risk populations: older and male students, and those with assessment problems related to the different modes of assessing clinical skills. Amelioration of these factors through appropriate support systems could minimize the proportion of students having to retake modules and create a more supportive academic environment. Further research might focus on exploring the proportion of students experiencing retakes in each country and thus determine factors that could contribute to high stakes towards retakes for each country so as to develop country specific solution and improved clinical skills assessment.

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