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Background and Aims: The scenario in medical education is changing with objective structured clinical examination (OSCE) being introduced as an assessment tool. Its successful implementation in anaesthesiology postgraduate evaluation process is still limited. We decided to to evaluate the effectiveness of OSCE and compare it to conventional examinations as formative assessment tools in anaesthesiology. Methods: We conducted a cross-sectional comparative study in defined population of anaesthesiology postgraduate students to evaluate the effectiveness of OSCE as compared to conventional examination as formative assessment tool in anaesthesiology. Thirty-five students appeared for the conventional examination on the 1st day and viva voce on the 2nd day and OSCE on the last day. At the conclusion of the assessment, all the students were asked to respond to the perception evaluation questionnaire. We analysed the perception of OSCE among the students. Results: Results showed a positive perception of the objective structured physical examination (OSCE) as well as structured 9 (25.7%), fair 19 (54.2%) and unbiased 13 (37.1%) with more standardised scoring 9 (25.7%). The students perceived OSCE to be less stressful than other examination. Thirty-one (88.5%) students agreed that OSCE is easier to pass than conventional method and 29 (82.5%) commented that the degree of emotional stress is less in OSCE than traditional methods. Conclusion: OSCE is better evaluation tool when compared to conventional examination.

The number of post-graduate rehabilitation therapists (novice therapists) is increasing due to the growing demand for rehabilitation services in Japan. This study investigated the acquisition status of Japanese novice therapists’ basic clinical skills to clarify their quality and characteristics. Eleven participants’ basic clinical skills (eight physical and three occupational therapists) were assessed using an Objective Structured Clinical Examination. Tasks included exercises of joint range of motion, muscle strengthening, getting up, standing up and sitting down, and transferring between wheelchair and bed. Assessment items were subdivided into categories: attitude, preparation, intervention, safety management, and feedback. One-way ANOVA and Friedman test were used for statistical analysis to compare the data between tasks and categories. The scores for each task’s achievement rate were not statistically significant. However, the achievement rate of each category including tasks was 92.6% (SD 4.0%) for attitude, 81.4% (SD 11.1%) for preparation, 77.9% (SD 14.7%) for intervention, 87.6% (SD 17.3%) for safety management, and 64.0% (SD 14.2%) for feedback. There were significant differences between attitude and feedback (p < 0.001), and between safety management and feedback (p = 0.012). Post-graduate training programs should focus on improving the quality of clinical skills, especially in skills related to feedback.

[...]it is essential to assess whether the objective of skill acquisition has been met. OSPE/OSCEs are conducted by means of rotating students in successive stations that assess students' skills in history taking, physical examination, communication skills, patient management, diagnosis, equipment usage in experiments, sequence of steps followed in experiments, and data interpretation. [5] The authors in previous studies have opinion that OSCE is a valid tool for assessing patient care, interpersonal and communication skills, and professionalism and is a reliable method for the evaluation of practice-based learning and improvement and system-based practice but not medical knowledge. [...]OPSE/OSCE has an imminent future in examination format.

Purpose: It aimed to compare the use of the tele-objective structured clinical examination (teleOSCE) with in-person assessment in high-stakes clinical examination so as to determine the impact of the teleOSCE on the assessment undertaken. Discussion follows regarding what skills and domains can effectively be assessed in a teleOSCE.Methods: This study is a retrospective observational analysis. It compares the results achieved by final year medical students in their clinical examination, assessed using the teleOSCE in 2020 (n=285), with those who were examined using the traditional in-person format in 2019 (n=280). The study was undertaken at the University of New South Wales, Australia.Results: In the domain of physical examination, students in 2020 scored 0.277 points higher than those in 2019 (mean difference=–0.277, P<0.001, effect size=0.332). Across all other domains, there was no significant difference in mean scores between 2019 and 2020.Conclusion: The teleOSCE does not negatively impact assessment in clinical examination in all domains except physical examination. If the teleOSCE is the future of clinical skills examination, assessment of physical examination will require concomitant workplace-based assessment.

Background Near-peer medical education serves as an important method of delivering education to junior students by senior students. Due to the reduced clinical exposure because of the COVID-19 pandemic, we developed a mentorship scheme to help medical students with their Integrated Structured Clinical Examinations (ISCEs) by providing a combination of near-peer mentorship together with lecture-based teaching on a weekly basis for a 12-week period. Students attended a specialty-focused lecture every Tuesday followed by a small group teaching session organised by their tutor. Methods A longitudinal evaluative interventional study was undertaken by the international student led medical education organisation, OSCEazy. The teaching programme was organised and conducted by third year medical students to a recruited cohort of second year medical students. Students’ perceptions of ISCEs (confidence, anxiety, and overall performance) were evaluated using 5-point Likert scales while their knowledge of the specialty was assessed using 10 single best answer questions which were distributed via Google® forms at the start and end of each week. In addition, we assessed tutor perceptions of their teaching and learning experience. Results Seventy-two tutees were enrolled in the programme (mean age: 24.4, female: 77.8%). 88.9% of the participants had not attended any online ISCE teaching prior to this. They preferred in-person ISCE teaching as compared to virtual sessions [median 4.5 (IQR 4–5) vs 3 (IQR 3–4), p  <  0.0001), respectively]. There was a significant overall increase in knowledge when comparing pre-session and post-session performance [mean 53.7% vs 70.7%, p  <  0.0001)]. There was a significant increase in student confidence [Confidence: median 3 (IQR:3–4) vs 4 (IQR 3–4), p  <  0.0001] while no change was seen in the anxiety and perception of their overall performance in an ISCE. [Anxiety: median 3 (IQR 2–4) vs 3 (IQR 3–4), p  = 0.37, Performance: median 3 (IQR 3–4) vs median 3 (IQR 3–4), p  <  0.0001]. The tutors reported an increase in their confidence in teaching ISCEs online [median 3 (IQR 2–3.25) vs median 4 (IQR 4–5), p  <  0.0001)]. Conclusion Online near-peer teaching increases the confidence of both tutees and tutors involved while enhancing the tutees’ knowledge of the specialty. Thus, medical schools should incorporate near-peer teaching in their curriculum to enhance the student learning experience.

Patient satisfaction and health care outcomes are directly linked to useful communication skills. Therefore, excellent interpersonal skills are imperative for health care professionals. Multiple mini-interview (MMI) is designed as a selection tool to assess the communication skills of applicants in medical schools during the admission process. However, objective structured clinical examination (OSCE) assesses students' communication and clinical skills at the end of their academic terms. Recently, Anglia Ruskin University, Chelmsford, UK, adopted MMI in the selection process for the first cohort of MSc Physician Associate trainees for the academic year 2015-2016. This study aimed to determine the likelihood of MMI as a predictor of future performance of communication skills in the OSCE. The anonymous data of the average scores of communication skills attained in MMI and OSCE at the end of year 1 were collected for 30 students from the Physician Associate program team. Subsequently, Pearson's correlation was computed to determine the relationship between the average scores of communication skills attained in MMI, and OSCE during trimester 2 and trimester 3 by the Physician Associate trainees. The study showed positive correlation between the scores of communication skills attained in MMI and OSCE during trimester 2 ( =0.956, n=30, <0.001) and trimester 3 ( =0.966, n=30, <0.001). The study provides empirical evidence for the validity of MMI as a predictor of future performance of Physician Associate trainees' communication skills during subsequent OSCEs.

Objective structured clinical examinations (OSCEs) are a widely recognized and accepted method to assess clinical competencies but are often resource-intensive. This study aimed to evaluate the feasibility and effectiveness of a virtual reality (VR)-based station (VRS) compared with a traditional physical station (PHS) in an already established curricular OSCE. Fifth-year medical students participated in an OSCE consisting of 10 stations. One of the stations, emergency medicine, was offered in 2 modalities: VRS and PHS. Students were randomly assigned to 1 of the 2 modalities. We used 2 distinct scenarios to prevent content leakage among participants. Student performance and item characteristics were analyzed, comparing the VRS with PHS as well as with 5 other case-based stations. Student perceptions of the VRS were collected through a quantitative and qualitative postexamination online survey, which included a 5-point Likert scale ranging from 1 (minimum) to 5 (maximum), to evaluate the acceptance and usability of the VR system. Organizational and technical feasibility as well as cost-effectiveness were also evaluated. Following randomization and exclusions of invalid data sets, 57 and 66 participants were assessed for the VRS and PHS, respectively. The feasibility evaluation demonstrated smooth implementation of both VR scenarios (septic and anaphylactic shock) with 93% (53/57) of students using the VR technology without issues. The difficulty levels of the VRS scenarios (septic shock: P=.67; anaphylactic shock: P=.58) were comparable to the average difficulty of all stations (P=.68) and fell within the reference range (0.4-0.8). In contrast, VRS demonstrated above-average values for item discrimination (septic shock: r'=0.40; anaphylactic shock: r'=0.33; overall r'=0.30; with values >0.3 considered good) and discrimination index (septic shock: D=0.25; anaphylactic shock: D=0.26; overall D=0.16, with 0.2-0.3 considered mediocre and <0.2 considered poor). Apart from some hesitancy toward its broader application in future practical assessments (mean 3.07, SD 1.37 for VRS vs mean 3.65, SD 1.18 for PHS; P=.03), there were no other differences in perceptions between VRS and PHS. Thematic analysis highlighted the realistic portrayal of medical emergencies and fair assessment conditions provided by the VRS. Regarding cost-effectiveness, initial development of the VRS can be offset by long-term savings in recurring expenses like standardized patients and consumables. Integration of the VRS into the current OSCE framework proved feasible both technically and organizationally, even within the strict constraints of short examination phases and schedules. The VRS was accepted and positively received by students across various levels of technological proficiency, including those with no prior VR experience. Notably, the VRS demonstrated comparable or even superior item characteristics, particularly in terms of discrimination power. Although challenges remain, such as technical reliability and some acceptance concerns, VR remains promising in applications of clinical competence assessment.

IntroductionHospital and ambulatory care systems are rapidly building their virtual care capacity in response to the novel coronavirus (COVID-19) pandemic. The use of resident trainees in telemedicine is one area of potential development and expansion. To date, however, training opportunities in this field have been limited, and residents may not be adequately prepared to provide high-quality telemedicine care.AimThis study evaluates the impact of an adapted telemedicine Objective Structured Clinical Examination (OSCE) on telemedicine-specific training competencies of residents.SettingPrimary Care Internal Medicine residents at a large urban academic hospital.Program DescriptionIn March 2020, the New York University Grossman School of Medicine Primary Care program adapted its annual comprehensive OSCE to a telemedicine-based platform, to comply with distance learning and social distancing policies during the COVID-19 pandemic. A previously deployed in-person OSCE on the subject of a medical error was adapted to a telemedicine environment and deployed to 23 primary care residents. Both case-specific and core learning competencies were assessed, and additional observations were conducted on the impact of the telemedicine context on the encounter.Program EvaluationThree areas of telemedicine competency need were identified in the OSCE case: technical proficiency; virtual information gathering, including history, collateral information collection, and physical exam; and interpersonal communication skills, both verbal and nonverbal. Residents expressed enthusiasm for telemedicine training, but had concerns about their preparedness for telemedicine practice and the need for further competency and curricular development.DiscussionPrograms interested in building capacity among residents to perform telemedicine, particularly during the COVID-19 pandemic, can make significant impact in their trainees’ comfort and preparedness by addressing key issues in technical proficiency, history and exam skills, and communication. Further research and curricular development in digital professionalism and digital empathy for trainees may also be beneficial.

IntroductionCovid-19 pandemic caused a pivot to online clinical education and assessment across the globe.ObjectivesTo explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examination.MethodsThis study was designed as interpretive descriptive qualitative research. All candidates and examiners of the online Irish Basic Specialist Training exam in September and November 2020 were included. The respondents were interviewed by Zoom which were transcribed verbatim. Data was coded using NVivo20 pro and Braun and Clarke thematic analysis was used to draw various themes and subthemes.ResultsA total of seven candidates and seven examiners from different training deaneries and specialties were interviewed with average duration of 29m 45s and 24m 20s respectively. The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking nonverbal cues. The candidates were very conscious of eye contact while examiners placed more emphasis on overall professional behavior and patient engagement. All candidates preferred to continue online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination due to some limitations in assessing physical and cognitive examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups.ConclusionsThe results of the study have shown different insights of two important stakeholders in a professional postgraduate psychiatry examination which can be useful to improve same exam and design similar assessments in other settings.DisclosureNo significant relationships.

BackgroundVaccine hesitancy is challenging for clinicians and of increasing concern since COVID-19 vaccination rollout began. Standardized patients (SPs) provide an ideal method for assessing resident physicians’ current skills, providing opportunity to practice and gain immediate feedback, while also informing evaluation of curriculum and training. As such, we designed and implemented an OSCE station where residents were tasked with engaging and educating a vaccine-hesitant patient.AimDescribe residents’ vaccine counseling practices, core communication and interpersonal skills, and effectiveness in meeting the objectives of the case. Explore how effectiveness in overcoming vaccine hesitancy may be associated with communication and interpersonal skills in order to inform educational efforts.SettingAnnual OSCE at a simulation center.Participants106 internal medicine residents (51% PGY1, 49% PGY2).Program DescriptionResidents participated in an annual residency-wide, multi-station OSCE, one of which included a Black, middle-aged, vaccine-hesitant male presenting for a routine video visit. Residents had 10 min to complete the encounter, during which they sought to educate, explore concerns, and make a recommendation. After each encounter, faculty gave residents feedback on their counseling skills and reviewed best practices for effective communication on the topic. SPs completed a behaviorally anchored checklist (30 items across 7 clinical skill domains and 2 measures of trust in the vaccine’s safety and resident) which will inform future curriculum.Program EvaluationFifty-five percent (SD: 43%) of the residents performed well on the vaccine-specific education domain. PGY2 residents scored significantly higher on two of the seven domains compared to PGY1s (patient education/counseling—PGY1: 35% (SD: 36%) vs. PGY2: 52% (SD: 41%), p = 0.044 and activation—PGY1: 37% (SD: 45%) vs. PGY2: 59% (SD: 46%), p = 0.016). In regression analyses, education/counseling and vaccine-specific communication skills were strongly, positively associated with trust in the resident and in the vaccine’s safety. A review of qualitative data from the SPs’ perspective suggested that low performers did not use patient-centered communication skills.DiscussionThis needs assessment suggests that many residents needed in-the-moment feedback, additional education, and vaccine-specific communication practice. Our program plans to reinforce evidence-based practices physicians can implement for vaccine hesitancy through ongoing curriculum, practice, and feedback. This type of needs assessment is replicable at other institutions and can be used, as we have, to ultimately shed light on next steps for programmatic improvement.