Abstract:Background: The educational process in different medical schools has been negatively affected by the COVID-19 pandemic worldwide. As a part of the Saudi government’s attempts to contain the spread of the virus, schools’ and universities’ educational activities and face-to-face lectures have been modified to virtual classrooms. The purpose of this study was to explore the perceptions of the faculty and the students of an electronic objective structured clinical examination (E-OSCE) activity that took place duri… Show more
“…Candidates could move 360° around the patient and a virtual script was created with responses activated according to which option the candidate selected, for example, “order exams” with a list of drop-down options to select [ 56 ]. Four studies reported the use of standardised patients [ 55 , 56 , 63 , 69 ] and seven included simulated patients [ 52 , 62 , 64 , 66 , 68 , 71 ]. Consultations between simulated patients, examiners and students were described as a three-way telehealth consultation with a focus on history-taking skills [ 66 ].…”
Section: Resultsmentioning
confidence: 99%
“…Consultations between simulated patients, examiners and students were described as a three-way telehealth consultation with a focus on history-taking skills [ 66 ]. Another study described examiners acting as standardised patients [ 69 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Additionally, several studies reported difficulties with internet connectivity. Four studies reported minor technological issues [ 60 , 61 , 67 , 69 ]. However, five studies reported no technological issues [ 53 , 57 , 62 , 68 , 71 ].…”
Introduction
Clinical examinations (assessments) are integral to ensuring that medical students can treat patients safely and effectively. The COVID-19 pandemic disrupted traditional formats of clinical examinations. This prompted Medical Schools to adapt their approaches to conducting these examinations to make them suitable for delivery in the pandemic. This systematic review aims to identify the approaches that Medical Schools, internationally, adopted in adapting their clinical examinations of medical students in response to the COVID-19 pandemic.
Methods
Three databases and four key medical education journals were systematically searched up to 22 October 2021; a grey literature search was also undertaken. Two reviewers independently screened at title, abstract stage and full text stage against predefined eligibility criteria. Discrepancies were resolved by discussion and involvement of senior authors. Risk of bias assessment was performed using an adapted version of a pre-existing risk of bias assessment tool for medical education developments. Results were summarised in a narrative synthesis.
Results
A total of 36 studies were included, which documented the approaches of 48 Medical Schools in 17 countries. Approaches were categorised into in-person clinical examinations (22 studies) or online clinical examinations (14 studies). Authors of studies reporting in-person clinical examinations described deploying enhanced infection control measures along with modified patient participation. Authors of studies reporting online clinical examinations described using online software to create online examination circuits. All authors reported that adapted examinations were feasible, scores were comparable to previous years’ student cohorts, and participant feedback was positive. Risk of bias assessment highlighted heterogeneity in reporting of the clinical examinations.
Conclusions
This review identified two broad approaches to adapting clinical examinations in the pandemic: in-person and online. Authors reported it was feasible to conduct clinical examinations in the pandemic where medical educators are given sufficient time and resources to carefully plan and introduce suitable adaptations. However, the risk of bias assessment identified few studies with high reporting quality, which highlights the need for a common framework for reporting of medical education developments to enhance reproducibility across wider contexts. Our review provides medical educators with the opportunity to reflect on past practises and facilitate the design and planning of future examinations.
“…Candidates could move 360° around the patient and a virtual script was created with responses activated according to which option the candidate selected, for example, “order exams” with a list of drop-down options to select [ 56 ]. Four studies reported the use of standardised patients [ 55 , 56 , 63 , 69 ] and seven included simulated patients [ 52 , 62 , 64 , 66 , 68 , 71 ]. Consultations between simulated patients, examiners and students were described as a three-way telehealth consultation with a focus on history-taking skills [ 66 ].…”
Section: Resultsmentioning
confidence: 99%
“…Consultations between simulated patients, examiners and students were described as a three-way telehealth consultation with a focus on history-taking skills [ 66 ]. Another study described examiners acting as standardised patients [ 69 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Additionally, several studies reported difficulties with internet connectivity. Four studies reported minor technological issues [ 60 , 61 , 67 , 69 ]. However, five studies reported no technological issues [ 53 , 57 , 62 , 68 , 71 ].…”
Introduction
Clinical examinations (assessments) are integral to ensuring that medical students can treat patients safely and effectively. The COVID-19 pandemic disrupted traditional formats of clinical examinations. This prompted Medical Schools to adapt their approaches to conducting these examinations to make them suitable for delivery in the pandemic. This systematic review aims to identify the approaches that Medical Schools, internationally, adopted in adapting their clinical examinations of medical students in response to the COVID-19 pandemic.
Methods
Three databases and four key medical education journals were systematically searched up to 22 October 2021; a grey literature search was also undertaken. Two reviewers independently screened at title, abstract stage and full text stage against predefined eligibility criteria. Discrepancies were resolved by discussion and involvement of senior authors. Risk of bias assessment was performed using an adapted version of a pre-existing risk of bias assessment tool for medical education developments. Results were summarised in a narrative synthesis.
Results
A total of 36 studies were included, which documented the approaches of 48 Medical Schools in 17 countries. Approaches were categorised into in-person clinical examinations (22 studies) or online clinical examinations (14 studies). Authors of studies reporting in-person clinical examinations described deploying enhanced infection control measures along with modified patient participation. Authors of studies reporting online clinical examinations described using online software to create online examination circuits. All authors reported that adapted examinations were feasible, scores were comparable to previous years’ student cohorts, and participant feedback was positive. Risk of bias assessment highlighted heterogeneity in reporting of the clinical examinations.
Conclusions
This review identified two broad approaches to adapting clinical examinations in the pandemic: in-person and online. Authors reported it was feasible to conduct clinical examinations in the pandemic where medical educators are given sufficient time and resources to carefully plan and introduce suitable adaptations. However, the risk of bias assessment identified few studies with high reporting quality, which highlights the need for a common framework for reporting of medical education developments to enhance reproducibility across wider contexts. Our review provides medical educators with the opportunity to reflect on past practises and facilitate the design and planning of future examinations.
“…It was indicated by students, examines and heads of clinical departments that online OSCE is an acceptable tool for assessing clinical skills other than physical examination skills. In a similar study in Saudi Arabia by Shaiba et al, 17 electronic OSCE (e-OSCE) was conducted in Pediatrics rotation and most of the respondents were very comfortable with this new virtual experience. More than half of the participants in that study even preferred the e-OSCE compared to the classic face-to-face clinical OSCE during the pandemic, which is supported also by a similar study by Elnaem et al 18 …”
“…Utilizing telecommunication platforms such as Zoom, traditional face-to-face OSCE scenarios were adapted for online delivery. This was proven to be done successfully in other health professions such as in a medical faculty [ 2 ]. There are many considerations before conducting a virtual OSCE, including ensuring that both examiners and students have the appropriate resources, including a functional device compatible with Zoom, a video camera, audio capabilities, and a good and stable internet connection.…”
Objective Structured Clinical Examinations (OSCEs) are routinely used in healthcare education programs. Traditionally, students undertake OSCEs as face-to-face interactions to assess competency in soft skills. Due to physical distancing restrictions during COVID-19, alternative methods were required. This study utilized a mixed-method design (online survey and interviews) to evaluate second-year pharmacy students’ and examiners’ experiences of their first virtual OSCEs in Australia. A total of 196 students completed their first virtual OSCE in June 2020 of which 190 students completed the online survey. However, out of the 190 students, only 88% (n = 167) consented to the use of the data from their online survey. A further 10 students and 12 examiners were interviewed. Fifty-five students (33%) who participated in the online survey strongly agreed or agreed that they preferred the virtual experience to face-to-face OSCEs while 44% (n = 73) neither agreed nor disagreed. Only 20% (n = 33) felt more anxious with the virtual OSCEs. Additionally, thematic analysis found non-verbal communication as a barrier during the OSCE. Positive aspects about virtual OSCEs included flexibility, decreased levels of anxiety and relevance with emerging telehealth practice. The need for remote online delivery of assessments saw innovative ways of undertaking OSCEs and an opportunity to mimic telehealth. While students and examiners embraced the virtual OSCE process, face-to-face OSCEs were still considered important and irreplaceable. Future opportunities for OSCEs to be delivered both face-to-face and virtually should be considered.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
