Background
This study of monitoring the effectiveness of the formative OSCE was conducted over five years from 2014 until 2018 and still this monitoring is going on for 2019. The purpose of this study is to determine the effectiveness of applying formative assessment Objective Structured Clinical Examination (OSCE) for undergraduate 5th year medical students in clinical skills module, Also to measure the effectiveness of Self Direct Learning (SDL) sessions. 

Methods
Check list of 10 questions survey (questionnaire) were distributed to all undergraduate medical students who had participated in the formative (OSCE) so to measure their competency and proficiency. The formative is conducted before summative OSCE. This method was applied in 2014 and the residents were the examiners. In 2018 this method was amended to accept more challenges in inviting house officers (interns) to be examiners. Since most of the standardized patients (SP) who are participating in the formative OSCE from Interns who have finished their rotations in all the clinical departments and were retained in the inactive stations. 

Results
The analyses were done thru cross tabulation by (NCSS) similar to SPSS version 20 of all the survey, and the data was summarized in the following table. In 2014, the number of students were 208 (95 males & 113 females) who participated in the formative assessment had reported not enough time since it was 5 minutes; it should more than 10 minutes. About 8% were incomplete questionnaire nothing to report.43% had reported it highlighted area of weaknesses in their clinical skills and 48% felt safe to make errors without accountability and confidentiality. But students had reported difficulty with the residents; they were inexperience to provide feedback since they were not involved in their teaching plane. In 2015 and 2016, about 50% of the students did not participate in the formative assessment OSCE since it was not compulsory. In 2018, we have accepted more challenges in inviting house officers (interns) to be examiners. All the incomplete surveys were discarded and omitted from the analysis. 

Conclusion
Overall, 5th year medical students' feedback was infavor of having formative (OSCE) more often in clinical skills module. The formative assessment is powerful tools had assisted them in learning and to overcome their weakness and gave them the opportunity to improvement and to prepare them for the summative (OSCE), as result repetition of this module was reduced, Also suggested that residents should be involved in teaching the curriculum to be familiar with students’ syllabus. 

Faculty had diversity of opinion about for formative OSCE which was reported that it's time consuming, budget consumption and lack of incentive; on the other hand, students expressed high satisfaction with this type of examination and their outcome after participating was found remarkably.