"We Need More Practice": Evaluating the Role of Virtual Mock OSCES in the Undergraduate Programme During the COVID Pandemic.

Background: Feedback collated at University College London Medical School (UCLMS) during the COVID pandemic identified how many students felt unprepared for their summative Objective Structured Clinical Examinations (OSCEs) despite attending mock face-to-face OSCEs. The aim of this study was to explore the role of virtual mock OSCES for improving student's sense of preparedness and confidence levels for their summative OSCEs. Methods: All Year 5 students (n=354) were eligible to participate in the virtual mock OSCEs and were sent a pre- and post-survey for completion. Hosted on Zoom in June 2021, each circuit comprised six stations, assessing history taking and communication skills only, in Care of the Older Person, Dermatology, Gynaecology, Paediatrics, Psychiatry and Urology. Results: Two hundred and sixty-six Year 5 students (n=354) participated in the virtual mock OSCEs, with 84 (32%) students completing both surveys. While a statistically significant increase in preparedness was demonstrated, there was no difference in overall confidence levels. In contrast, between specialties, a statistically significant increase in confidence levels was seen in all specialties barring Psychiatry. Despite half of the participants highlighting how the format did not sufficiently represent the summative OSCEs, all expressed interest in having virtual mock OSCEs incorporated into the undergraduate programme. Conclusion: The findings of this study suggest that virtual mock OSCEs have a role in preparing medical students for their summative exams. While this was not reflected in their overall confidence levels, this may be due to a lack of clinical exposure and higher anxiety levels among this cohort of students. Although virtual OSCEs cannot replicate the "in-person" experience, considering the logistical advantages, further research is required on how these sessions can be developed, to support the traditional format of face-to-face mock OSCEs within the undergraduate programme.

Enhancing medical students` confidence and performance in integrated structured clinical examinations (ISCE) through a novel near-peer, mixed model approach during the COVID-19 pandemic.

BACKGROUND: Near-peer medical education serves as an important method of delivering education to junior students by senior students. Due to the reduced clinical exposure because of the COVID-19 pandemic, we developed a mentorship scheme to help medical students with their Integrated Structured Clinical Examinations (ISCEs) by providing a combination of near-peer mentorship together with lecture-based teaching on a weekly basis for a 12-week period. Students attended a specialty-focused lecture every Tuesday followed by a small group teaching session organised by their tutor. METHODS: A longitudinal evaluative interventional study was undertaken by the international student led medical education organisation, OSCEazy. The teaching programme was organised and conducted by third year medical students to a recruited cohort of second year medical students. Students' perceptions of ISCEs (confidence, anxiety, and overall performance) were evaluated using 5-point Likert scales while their knowledge of the specialty was assessed using 10 single best answer questions which were distributed via Google® forms at the start and end of each week. In addition, we assessed tutor perceptions of their teaching and learning experience. RESULTS: Seventy-two tutees were enrolled in the programme (mean age: 24.4, female: 77.8%). 88.9% of the participants had not attended any online ISCE teaching prior to this. They preferred in-person ISCE teaching as compared to virtual sessions [median 4.5 (IQR 4-5) vs 3 (IQR 3-4), p <  0.0001), respectively]. There was a significant overall increase in knowledge when comparing pre-session and post-session performance [mean 53.7% vs 70.7%, p <  0.0001)]. There was a significant increase in student confidence [Confidence: median 3 (IQR:3-4) vs 4 (IQR 3-4), p <  0.0001] while no change was seen in the anxiety and perception of their overall performance in an ISCE. [Anxiety: median 3 (IQR 2-4) vs 3 (IQR 3-4), p = 0.37, Performance: median 3 (IQR 3-4) vs median 3 (IQR 3-4), p <  0.0001]. The tutors reported an increase in their confidence in teaching ISCEs online [median 3 (IQR 2-3.25) vs median 4 (IQR 4-5), p <  0.0001)]. CONCLUSION: Online near-peer teaching increases the confidence of both tutees and tutors involved while enhancing the tutees' knowledge of the specialty. Thus, medical schools should incorporate near-peer teaching in their curriculum to enhance the student learning experience.

The Impact of the COVID-19 Pandemic on Veterinary Clinical and Professional Skills Teaching Delivery and Assessment Format.

The limitations posed by the COVID-19 pandemic have been particularly challenging for courses teaching clinical and professional skills. We sought to identify how the COVID-19 pandemic has impacted the delivery of veterinary clinical and professional skills courses, including modifications to teaching and assessment, and to establish educators' perceptions of the efficacy of selected delivery methods. A branching survey was deployed to 35 veterinary schools in North America in March and April 2021. The survey collected data about curriculum and assessment in spring 2020, fall 2020, and spring 2021. Educators at 16 veterinary schools completed the survey (response rate: 46%). Educators quickly adapted curriculum to meet the requirements of their institutions and governments. Early in the pandemic (spring 2020), curriculum was delayed, delivered remotely, or canceled. Assessment methods frequently included virtual objective structured clinical examinations (OSCEs) and video-recorded skills assessments. Later in the pandemic (fall 2020, spring 2021), in-person clinical skills sessions resumed at many schools, often in smaller groups. Professional skills instruction typically remained virtual, as benefits were noted. Assessment methods began to normalize with in-person OSCEs resuming with precautions, though some school maintained virtual assessments. Educators noted some advantages to instructional methods used during COVID, including smaller group sizes, better prepared students, better use of in-person lab time, more focus on essential course components, provision of models for at-home practice, and additional educators' remote involvement. Following the pandemic, educators should consider retaining some of these changes while pursuing further advancements, including improving virtual platforms and relevant technologies.

Virtually prepared! Student-led online clinical assessment.

The transition of medical education from a face-to-face to virtual setting due to the ongoing COVID-19 restrictions has been challenging. While both students and educators have now somewhat settled into new teaching methods, from Zoom™ lectures to online tutorials, the adaption of clinical skills teaching to the virtual setting has lagged behind. As a result, many students have been left feeling anxious and concerned about practicing practical and communication skills that are central to being a competent and safe doctor. In light of this, medical students at the Queen's University Belfast General Practice (GP) Society organised a series of virtual, mock Objective Structured Clinical Examinations (OSCEs) for students in Years 2-5 conducted via Zoom™. Medical students and doctors acted as examiners and simulated patients (SPs) with 'breakout rooms' being used to simulate distinct OSCE stations. This collaborative project was well received by participants and doctors alike, who found the virtual OSCEs improved their confidence in performing key clinical skills and virtual consultations. As medical students ourselves, we gained early career exposure to designing and delivering assessments and developed transferable skills, relevant both to medicine and teaching. Lastly, the peer-led approach disrupted the traditional hierarchy in medical education. Students are a key, and often overlooked, resource to overcoming challenges in medical education and educators should encourage students to become involved in medical education at an early stage in their careers.