Number of Citations: 0

Submitted: 24 May 2022
Accepted: 16 August 2022
Published online: 3 January, TAPS 2023, 8(1), 51-53
https://doi.org/10.29060/TAPS.2023-8-1/CS2818

Teresa Diana B. Bongala

Department of Obstetrics and Gynaecology, Faculty of the College of Medicine, University of the East Ramon Magsaysay Memorial Medical Centre, Philippines

I. INTRODUCTION

The world will never be the same after the COVID-19 pandemic. Education has had to evolve. Evaluation of cognitive skills is still achieved by written examinations administered through learning management systems. However, an integral part of evaluation, the Objective Structured Clinical Examination (OSCE), which assesses the students’ ability to obtain, communicate information, perform physical examination, diagnose, and solve problems, could not be given due to COVID-19 restrictions.

Simulation during teaching and assessments like the OSCE have been done worldwide, (Nguyen et al., 2015) and have been utilised in our university for more than twenty years.  Because of lockdowns due to Covid-19, the OSCE was given online in medical schools worldwide, however the number of students were limited (Boyle et al., 2020; Lara et al., 2020).  In the Philippines, by December 2020, immunisation against Covid-19 had not started, and travel was still restrictive, hence face-to-face classes were still limited. (Department of Education, 2020). Hence, the Department of Obstetrics and Gynaecology of our university planned and conducted the first large-scale summative virtual OSCE (VOSCE) for Level III medical students. 

II. METHODS

The summative VOSCE was conducted using a Zoom licensed Education account, with features called “Breakout Rooms” and “Screen Share” and the Canvas learning management system. There were 17 faculty, 10 residents, 15 post-graduate interns, 10 Level IV and 440 Level III students who participated. The Level III students had synchronous and asynchronous lectures for four-and-a-half months in Obstetrics, and nine weeks of small group discussions (SGD).

The table of specifications was based on the learning outcomes in Obstetrics and skills taught during SGDs. Six sets of examinations with four stations, were prepared.  The first two stations were given in Canvas, while the last two “performance” stations, namely history taking, and Physical Examination (PE) were given over Zoom. The evaluation in OSCE was modified to fit tasks for VOSCE. It underwent an MPL setting by three members of the faculty using the Angoff method. (Livingston & Zieky, 1982)

All participants underwent orientation. The students were informed of the materials they needed: a computer, for Canvas and for zoom in stations 3 and 4; a mobile device, for proctoring, communication and to demonstrate performance /PE in Station 4; and other materials needed for Station 4.  The faculty were instructed to Screen Share tasks via Zoom in the “performance” stations and oriented on student evaluation and result submission.

Three days before the VOSCE, a simulation involving clinical clerks, post-graduate interns and residents was conducted. Clarity of video, audio and internet speed were checked.  Timing and transfer of examinees between breakout rooms was also rehearsed. The tasks for Stations 3 and 4, and evaluation forms, were sent to the faculty the 12 hours before the VOSCE. 

Thirty minutes before the VOSCE, the students underwent identity verification, their gadgets and positions checked.  Concurrently, the post-graduate interns, who acted as patients, were given the script.

The examinees, in stations 1 and 2, givenclinical vignette and images of speculum examination, had to diagnose and write a prescription.  After Canvas stations, in another breakout room, the students were informed of materials needed for Station 4.  In Station 3, they elicited the history from a simulated patient, and in Station 4, they performed PE with annotation.

Communication with students was through Telegram and Zoom, while Viber was used between faculty and residents.

III. RESULTS

Four hundred and forty students took part in the VOSCE. Post-VOSCE survey with 397 respondents showed that 382 (96.2%) students took it in the Philippines, and 15 (0.38%) students were out of the country. 

Forty-three (10.8%) had internet speed <10mbps. Thirty (9.0%) had connection problems/unable to view images in stations 1 and/or 2. Thirty students were given another examination, three hours post-VOSCE. Table 1 shows the location and the internet connection of the students, their perception of the VOSCE and the problems they encountered during the examination.