Evaluation of virtual assessment 

Abstract

BackgroundThe study emerged from the necessity to reschedule an in-person long case examination to an online platform for Physician Associate students’ final clinical examination. The group had already experienced a delay in taking this clinical examination due to missing clinical hours, during Covid-19 restrictions. The aim of this study was to evaluate the experiences of students and examiners for a high stakes’ clinical examination online. Research suggests that the long case is the only clinical examination that promotes holistic assessment. However, a disconnect between the patient’s presence and the student in the virtual environment was a key finding in this study. Methods This was an evaluation research study, using the Context, Input, Process, Product (CIPP) model, which provided a framework to establish the effectiveness and/or success of an online format for a high stakes’ clinical examination. All students and examiners were invited to take part in virtual interviews. ResultsResults suggest that both students (n=5) and examiners (n=7) agree that, while the stress of a face-to-face examination was lessened for the student, this was balanced by a new stressor of potential internet problems. All agreed that a virtual setting for a high stakes assessment is not transferable, with both groups citing the lack of opportunities to ‘read the patient’ and ‘showcase their physical exam skills’ as challenging. Conclusions Our study suggests that, in the context of balancing the risks of the pandemic with graduating healthcare professionals, the online format was a success. The benefits cited included the preparation of students for real life situations in a clinical setting, with a healthcare system now more reliant on virtual consultations, and the capacity to offer increased opportunities for formative assessment of consultation and clinical reasoning skills. However, recommendations suggest that the long case could be planned so that student and patient are in the same setting to perform a ten-minute physical exam, confirming the finding that questions on ‘how to’ examine a patient are no substitute for ‘doing’.