Virtual clinical assessment in medical education: an investigation of online conference technology

As a result of the Covid-19 pandemic, medical education institutions were suddenly and unexpectedly faced with making significant changes in delivering their clinical assessments to comply with social distancing requirements and limited access to clinical education centres. Seeking a potential solution to these new circumstances, we designed, implemented and evaluated an online virtual OSCE, as a ‘proof of concept’ intervention study. Our qualitative research involved document analysis of the stages of decision-making and consultation in designing the intervention, and thematic analysis based on the perspectives and experiences of the key stakeholders (final year students, clinical examiners, simulated patients and faculty staff who acted as station assistants), gathered through surveys with Likert-scale questions and free text comments, and online discussion groups which were recorded and transcribed. From our analysis, we identified four themes: optimising assessment design for online delivery, ensuring clinical authenticity, recognising and addressing feelings and apprehensions, and anticipating challenges through incident planning and risk mitigation. Through the data gathered at each stage of the intervention, and the involvement of key stakeholders in the design and evaluation, our study highlights examples of effective practice for future applications of online technologies in assessment, provides guidance for designing and implementing online virtual assessment, and lays a foundation for comparative, longitudinal research on the significant and increasing roles played by technology in healthcare professional education and practice.