Abstract
BACKGROUND: Simulated patients (SPs) are widely used in medical education to help students acquire clinical skills in a safe and realistic setting. In fields such as obstetrics and gynaecology (OB-GYN), where real-patient interactions can be limited due to cultural sensitivities-especially in Gulf Cooperation Council (GCC) countries-SPs play a crucial role in medical education. This study aimed to validate the training of SPs for assessing OB-GYN history-taking skills and explore the perceptions of stakeholders - including faculty, students, leadership and SPs - regarding the implementation, challenges and potential improvements of the SP programme. METHODS: A mixed-methods research design was employed in this study. During the quantitative phase, training of SPs using a structured OB-GYN history-taking module was conducted, followed by an evaluation of their performance by expert raters. The inter-rater reliability was assessed using Fleiss' Kappa and Cronbach's alpha. In the qualitative phase, semi-structured interviews and focus groups were conducted with students, SPs, faculty trainers and academic leaders. Thematic analysis was performed to identify common themes and divergent viewpoints. RESULTS: Quantitative results showed moderate-to-high inter-rater reliability, indicating consistent and effective SP performance post-training. Qualitative findings revealed that stakeholders perceived that the usage of SPs results in the enhancement of student engagement, realism and communication skills. However, challenges such as cultural sensitivities, limited SP diversity and logistical constraints were highlighted. Stakeholders emphasised the need for culturally contextualised training, periodic feedback loops and institutional support. CONCLUSIONS: The study confirms that structured training can effectively prepare simulated patients for OB-GYN education in GCC settings. By integrating stakeholder feedback, this study provides valuable insights for refining SP programmes and addressing region-specific challenges. A more culturally aware and well-supported SP programme can boost student confidence and improve learning outcomes in sensitive clinical areas like OB-GYN.