Changes to objective structured clinical examinations (OSCE) at Australian medical schools in response to the COVID-19 pandemic

Abstract

Introduction

Objective Structured Clinical Examinations (OSCE) are used to assess clinical skills. We investigated how exit OSCEs changed in Australian medical schools in response to the COVID-19 pandemic.

Materials and Methods

The lead ACCLAiM assessment academic from 12 eligible Australian medical school members of the Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM) received a 45-item semi-structured online questionnaire.

Results

All schools (12/12) responded. Exit OSCEs were not used by one school in 2019, and 3/11 schools in 2020. Of eight remaining schools, four reduced station numbers and testing time. The minimum OSCE testing time decreased from 64 min in 2019 to 54 min in 2020. Other modifications included: a completely online ‘e-OSCE’ (n = 1); hybrid delivery (n = 4); stations using: videos of patient encounters (n = 3), telephone calls (n = 2), skill completion without face-to-face patient encounters (n = 3). The proportion of stations involving physical examination reduced from 33% to 17%. Fewer examiners were required, and university faculty staff formed a higher proportion of examiners.

Conclusions

All schools changed their OSCEs in 2020 in response to COVID-19. Modifications varied from reducing station numbers and changing delivery methods to removing OSCE and complete assessment re-structuring. Several innovative methods of OSCE delivery were implemented to preserve OSCE validity and reliability whilst balancing feasibility.

Keywords:

• OSCE
• clinical examination
• medical education
• Australian medical schools

Acknowledgements

The authors would like to thank administrative and academic staff from all participating schools.

Ethical approval

The project was approved by the James Cook University Human Research Ethics Committee (approval number H5595).

Glossary

Defensibility: The defensibility of an assessment is its ability to withstand legal challenges. In order for an assessment to be defensible, it must be valid, reliable and fair, and there must be evidence available to demonstrate this in case of a legal challenge.

https://www.questionmark.com/defensibility-and-legal-certainty-for-tests-and-exams/

Disclosure statement

The authors have no conflicts of interest to declare.

Author contributions

All authors contributed to questionnaire design, data acquisition, drafting/revising the manuscript and approved the final version of the manuscript to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. In addition, CH was responsible for study conceptualisation and design, and CH and LH performed data analysis.

Additional information

Notes on contributors

C. Heal

Dr. Clare Heal, MBChB, DRANZCOG, DipGUMed, MPHTM, PhD, is a Professor and Academic Lead for General Practice at James Cook University and is based at the Rural Clinical School in Mackay, Queensland. In addition to her research activities, she is a chair of Year 5 assessment. She is a member of an expert exam item-writing panel for the Australian Medical Council and is former co-chair of ACCLAIM.

K. D’Souza

Karen D’Souza, MBBS (Hons), is the Student Welfare and Academic Progression Lead and chairs Year 3 and 4 in the Doctor of Medicine course at the School of Medicine, Deakin University. She is a Co-Chair of the ACCLAiM Collaboration (Australian Collaboration for Clinical Assessment in Medicine). Her areas of research interest include OSCEs, professionalism, clinical and communication skills.

L. Hall

Dr Leanne Hall, BPhty (Hons), PhD, is an academic in the College of Medicine and Dentistry, James Cook University, Australia. In addition to supervision of 5^th and 6^th year honours students, Leanne’s research interests include low back pain, women’s health and antibiotic stewardship.

J. Smith

Dr Jane Smith, MBBS, FRACGP, MHS, is an Associate Professor and Head of General Practice, Bond University Medical Program. Jane became a full time academic after many years favouring clinical GP, and vocational training, over academia. As well as educating medical students in General Practice, she has been responsible for many Clinical Year Examinations, creating research interests in OSCE assessments, medical education and general practice.

K. Jones

Dr Karina Jones, BAnVetBioSc (Hons), PhD, is an academic in the College of Medicine and Dentistry, James Cook University, Australia. Her research interests include clinical assessment, medical education and activities associated with the Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM).

Dr. Clare Heal, MBChB, DRANZCOG, DipGUMed, MPHTM, PhD, is a Professor and Academic Lead for General Practice at James Cook University and is based at the Rural Clinical School in Mackay, Queensland. In addition to her research activities, she is a chair of Year 5 assessment. She is a member of an expert exam item-writing panel for the Australian Medical Council and is former co-chair of ACCLAIM.

Karen D’Souza, MBBS (Hons), is the Student Welfare and Academic Progression Lead and chairs Year 3 and 4 in the Doctor of Medicine course at the School of Medicine, Deakin University. She is a Co-Chair of the ACCLAiM Collaboration (Australian Collaboration for Clinical Assessment in Medicine). Her areas of research interest include OSCEs, professionalism, clinical and communication skills.

Dr Karina Jones, BAnVetBioSc (Hons), PhD, is an academic in the College of Medicine and Dentistry, James Cook University, Australia. Her research interests include clinical assessment, medical education and activities associated with the Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM).