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A mixed-methods, validity informed evaluation of a virtual OSCE for undergraduate medicine clerkship
Giovanna Sirianni1, Jenny S. H. Cho2, David Rojas3, Jana Lazor1, Glendon Tait4, Yuxin Tu2, Joyce Nyhof-Young1, Kulamakan Kulasegaram1
1 Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
2 MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
3 MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
4 MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Correspondence Address:
Dr. Giovanna Sirianni
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario M5G 1V7
Canada
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/EHP.EHP_3_22
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Background: Pandemic-related learning environment disruptions have threatened clinical skills development and assessment for medical students and prompted a shift to virtual objective structured clinical examinations (vOSCEs). This study explores the benefits/limitations of vOSCEs from the perspective of key stakeholders and makes recommendations for improving future vOSCEs. Materials and Methods: Using a mixed-methods, utilization-focused program evaluation, we looked at feasibility and implementation evidence that addresses content, response process, and feasibility as per Messick’s validity framework. The analysis of test data was reviewed to inform reliability, acceptability, and consequential validity. A 14-question online survey was sent to both students and faculty followed by stakeholder focus groups. Descriptive statistics were collected, and deidentified transcripts independently reviewed and analyzed via constant, comparative, and descriptive thematic analysis. Results: The survey results showed the vOSCE was a feasible option for assessing history-taking, clinical reasoning, and counseling skills. Limitations were related to assessing subtle aspects of communications skills, physical examination competencies, and technical disruptions. Beyond benefits and drawbacks, major qualitative themes included recommendations for faculty development, technology limitations, professionalism, and equity in the virtual environment. The reliability of the six vOSCE stations reached a satisfactory level with a G-coefficient of 0.51/0.53. Conclusions: The implementation of a virtual, summative clerkship OSCE demonstrated adequate validity evidence and feasibility. The key lessons learned relate to faculty development content and ensuring equity and academic integrity. Future study directions include examining the role of vOSCEs in the assessment of virtual care competencies and the larger role of OSCEs in the context of workplace-based assessment and competency-based medical education. |
