Evaluating the feasibility and effectiveness of e- OSCE in the COVID- 19 era

Abstract

Background: The emergence of coronavirus disease 2019 (COVID-19) and its quick progress to a global pandemic has urged medical schools to shift from didactic to distance learning and assessment approaches. The quality of clinical training and assessment have been jeopardized due to the regulatory restrictions and potential hazards to human lives. The aim of this paper is to evaluate the feasibility and effectiveness of an electronic Objective Structured Clinical Examination (e-OSCE), which attempted to transform the format of a face-to-face OSCE to an e-OSCE.Methods: We conducted three end of clerkship e-OSCEs for final year medical students in Surgery, Medicine and Family Medicine using teleconferencing application of Microsoft Teams (MST). The e-OSCE blueprint included the assessment of all clinical skills except physical examination and procedural skills. Examiners supervised e-OSCE from the college campus while all students were remotely assessed through the MST channels. During the exam, the students stayed in their specified MST channels, examiners rotated across all students. The feasibility and effectiveness of e-OSCE was evaluated using a self-administered questionnaire to students, examiners and e-OSCE team. Results: The data analysis showed that 93.4% students and 92.2% examiners agreed with the quality and process of e-OSCE. Similarly, 83.6% students and 98% examiners agreed with the fairness, smoothness and organization of e-OSCE. As many as 45.9% students and 74.5% examiners agreed that e-OSCE was close to real life practice. Approximately one fifth of students and one third of examiners preferred e-OSCE over the face-to-face OSCE. The analysis of qualitative data generated themes of e-OSCE structure and technology. While majority of participants were satisfied with e-OSCE, students were concerned about examiners’ training and e-OSCE contents. Examiners and e-OSCE team recognized the paper-less, tech-savy, fast and reliable e-OSCE format. Conclusion: During and beyond COVID- 19 era, e-OSCE is a feasible and effective modality for assessing clinical competence except for physical examination and procedural skills. The planning and implementation of e-OSCE reflects an ingenuity in assessment of clinical competencies of medical students.

Adaptations in clinical examinations of medical students in response to the COVID-19 pandemic: a systematic review

“…Once the candidate-patient encounters were complete, candidates filled in their post encounter notes and were placed back into the main Zoom room, and the process repeated for the next case [ 60 , 63 ]. Other studies reported using similar functions in Microsoft Teams [ 37 , 52 , 62 , 68 , 71 ], where candidates remained in a ‘channel’ while simulated patients and examiners rotated between candidates. (Fig.…”

“…There was considerable variation between studies in the approach to patient participation in stations. Four studies described holding examinations without real or simulated patients [ 37 , 53 , 57 , 66 ]; examiners asked candidates questions based on sequential images or laboratory results shared with the candidate using the ‘share-screen’ function of Zoom [ 53 ], or Microsoft Teams [ 37 , 62 ]. In addition, candidates were questioned on what they would then ask patients in their history to formulate a diagnosis [ 37 , 53 ].…”

“…Four studies described holding examinations without real or simulated patients [ 37 , 53 , 57 , 66 ]; examiners asked candidates questions based on sequential images or laboratory results shared with the candidate using the ‘share-screen’ function of Zoom [ 53 ], or Microsoft Teams [ 37 , 62 ]. In addition, candidates were questioned on what they would then ask patients in their history to formulate a diagnosis [ 37 , 53 ]. Two studies incorporated virtual patients [ 56 , 60 ]; authors in one study created a 3D virtual patient in a consultation room (Fig.…”

“…Overall, study authors reported positive feedback from participants and stakeholders regarding online examinations [ 37 , 54 , 56 , 58 , 60 , 62 , 66 , 68 – 71 ]. Eight studies also described how stakeholders greatly valued the training, internet and bandwidth checks, as well as the briefings given to them before the examination [ 56 , 59 , 61 , 64 , 66 , 68 , 71 ].…”

Usefulness of Augmented Reality as a Tool to Support Online Learning

“…It is happened due to unawareness of covid-19 and took unpredictable time to cure purely (transition time). The transition can be decomposed into several interconnected dimensions that impact the feasibility and the quality of the distance learning provided [10] [11].…”