Are remote clinical assessments a feasible and acceptable method of assessment? A systematic review

Abstract

The COVID-19 pandemic presented an enormous and immediate challenge to assessing clinical skills in healthcare professionals. Many institutions were unable to deliver established face-to-face assessment methods such as Objective Structured Clinical Examinations (OSCEs). Assessors needed to rapidly institute alternative assessment methods to ensure that candidates met the clinical competences required for progression. Using a systematic review, we aimed to evaluate the feasibility, and acceptability of remote methods of clinical skills assessment, including remote structured clinical assessments and the submission of video recordings. We searched for studies reporting on Remote Clinical Assessments or its variants in MEDLINE, Embase and The Cochrane library from 2000 to March 2021. Twenty eight studies were included in the review; 20 studies related to remote structured clinical examinations or OSCEs and 8 reported the use of video submissions. The participants of the different studies included medical students, nursing students, dental students and doctors in training. A variety of different online platforms were utilised including Zoom, Skype, webcams, and Adobe Connect online. The studies found that delivery of remote clinical assessments is possible and provides an alternative method of assessing many clinical skills, but most also acknowledge limitations and challenges. They are acceptable to both candidates and examiners, and where measured, show moderate agreement with on-site clinical assessments. Current evidence is based on studies with low methodological quality and for the most part, small sample sizes.

Keywords:

• OSCE
• clinical skills
• assessments

Acknowledgements

SKK is supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. These sources had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Additional information

Notes on contributors

Setor K. Kunutsor

Setor K. Kunutsor is a Senior Lecturer in Evidence Synthesis at the University of Bristol Medical School.

Elizabeth P. Metcalf

Elizabeth P. Metcalf is a Reader and Director of Clinical Assessments at Cardiff Medical School. She sits on the Advisory Board of the Medical Schools Council Assessment Alliance (MSC-AA) and is a General Medical Practitioner (GP).

Rachel Westacott

Rachel Westacott is a Senior Lecturer in Medical Education at Birmingham Medical School. She sits on the Advisory Board of the Medical Schools Council Assessment Alliance and is a consultant physician.

Lisa Revell

Lisa Revell is an Academic Clinical Fellow in the Centre for Academic Primary Care, Bristol Medical School.

Andrew Blythe

Andrew Blythe is Professor of Medical Education and Director of Assessments and Feedback at Bristol Medical School. He sits on the Advisory Board of the Medical Schools Council Assessment Alliance and is a GP.