{"id":71959,"date":"2022-12-20T08:32:58","date_gmt":"2022-12-20T00:32:58","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/taps\/?post_type=issues&p=71959"},"modified":"2023-04-04T08:16:38","modified_gmt":"2023-04-04T00:16:38","slug":"conducting-a-large-scale-summative-virtual-osce-vosce-in-a-university-medical-centre-during-the-covid-19-pandemic","status":"publish","type":"issues","link":"https:\/\/medicine.nus.edu.sg\/taps\/issues\/conducting-a-large-scale-summative-virtual-osce-vosce-in-a-university-medical-centre-during-the-covid-19-pandemic\/","title":{"rendered":"Conducting a large-scale summative Virtual OSCE (VOSCE) in a University Medical Centre during the COVID-19 pandemic"},"content":{"rendered":"

Submitted: 24 May 2022
\r\nAccepted: 16 August 2022
\r\nPublished online: 3 January, TAPS 2023, 8<\/span>(1), 51-53<\/span>
\r\nhttps:\/\/doi.org\/10.29060\/TAPS.2023-8-1\/CS2818<\/a><\/p>\r\n

Teresa Diana B. Bongala<\/span><\/span><\/p>\r\n

Department of Obstetrics and Gynaecology, Faculty of the College of Medicine, University of the East Ramon Magsaysay Memorial Medical Centre, Philippines<\/span><\/i><\/p>\r\n

<\/span>I. INTRODUCTION<\/span><\/strong><\/p>\r\n

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\u2019 ability to obtain, communicate information, perform physical examination, diagnose, and solve problems, could not be given due to COVID-19 restrictions.<\/span><\/p>\r\n

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.\u00a0 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).\u00a0 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.\u00a0<\/span><\/span><\/p>\r\n

<\/span>II. METHODS<\/span><\/strong><\/p>\r\n

The summative VOSCE was conducted using a Zoom licensed <\/span>Education account, with features called \u201cBreakout Rooms\u201d and \u201cScreen Share\u201d 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\u00a0small group discussions (SGD). <\/span><\/p>\r\n

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.\u00a0 The first two stations were given in Canvas, while the last two \u201cperformance\u201d 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<\/span> <\/span>method. (Livingston & Zieky, 1982) <\/span><\/p>\r\n

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,\u00a0for proctoring, communication and to demonstrate performance \/PE in Station 4; and other materials needed for Station 4.\u00a0\u00a0The faculty were instructed to Screen Share tasks via Zoom in the \u201cperformance\u201d stations and oriented on student evaluation and result submission. <\/span><\/span><\/p>\r\n

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.\u00a0 Timing and transfer of examinees between breakout rooms was also <\/span>rehearsed<\/span>. The tasks for Stations 3 and 4, and evaluation forms, were sent to the faculty the 12 hours before the VOSCE.\u00a0<\/span><\/p>\r\n

Thirty minutes before the VOSCE, the students underwent identity verification, their gadgets and positions checked.\u00a0 Concurrently, the post-graduate interns, who acted as patients, were given the script.<\/span><\/p>\r\n

The examinees, in stations 1 and 2, given<\/span>clinical vignette and images of speculum examination, had to diagnose and write a prescription.\u00a0 After Canvas stations, in another breakout room, the students were informed of materials needed for Station 4.\u00a0 In Station 3, they elicited the history from a s<\/span>imulated<\/span> patient, and in Station 4, they performed PE with annotation. <\/span><\/p>\r\n

Communication with students was through Telegram and Zoom, while Viber was used between faculty and residents.<\/span><\/p>\r\n

<\/span>III. RESULTS<\/span><\/strong><\/p>\r\n

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.\u00a0<\/span><\/p>\r\n

Forty-three (10.8%) had internet speed <<\/u>10mbps. <\/span>Thirty <\/span>(9.0%) <\/span>had connection problems\/unable to view images <\/span>in<\/span> stations 1 and\/or 2<\/span>. Thirty students were given another examination,<\/span> three hours post-VOSCE<\/span>. 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.<\/span><\/p>\r\n

\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
\r\n

Questions <\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

Number (%)\u00a0<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Location during VOSCE<\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

\u00a0 \u00a0 Philippines (except Manila)<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0MetroManila\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0Outside of Philippines <\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

230 (57.93 %)<\/span><\/span><\/p>\r\n

152 (38.28%)<\/span><\/span><\/p>\r\n

15 (3.87%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Internet speed (mbps) <\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

\u00a0 \u00a0 < 10\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a010-100 <\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0> 100 <\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

\u00a0 43 (10.8%)<\/span><\/span><\/p>\r\n

328 (82.61%)\u00a0\u00a0<\/span><\/span><\/p>\r\n

\u00a026 (6.5%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Orientation<\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

Adequate<\/span><\/span><\/p>\r\n

Inadequate<\/span><\/span><\/p>\r\n

Absent <\/span><\/p>\r\n<\/td>\r\n

\r\n

336 (84.63%)<\/span><\/span><\/p>\r\n

\u00a047 (11.84%)<\/span><\/span><\/p>\r\n

\u00a014 (3.52%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

SGDs helpful\u00a0<\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

Strongly agree\/Agree\u00a0<\/span><\/span><\/p>\r\n

Neutral\u00a0<\/span><\/span><\/p>\r\n

Disagree\/strongly disagree<\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

319 (80.3%)<\/span><\/span><\/p>\r\n

58 (14.6 %)<\/span><\/span><\/p>\r\n

20 (5.03%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Canvas rubrics helpful\u00a0<\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

\u00a0 \u00a0 Strongly agree\/ Agree\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0Neutral\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0Disagree \/Strongly disagree<\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

335 (84.38%)<\/span><\/span><\/p>\r\n

\u00a049 (12.3 %)<\/span><\/span><\/p>\r\n

\u00a013 (3.3%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

VOSCE problems<\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

\u00a0 \u00a0 None<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0Temporary disconnection\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0Disconnection Stations 1\/or2\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0Internet lag<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0Poor audio<\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

265 (66.75%)<\/span><\/span><\/p>\r\n

\u00a063 (15.86%)<\/span><\/span><\/p>\r\n

\u00a030 (9.00%)<\/span><\/span><\/p>\r\n

\u00a024 (6.04%)<\/span><\/span><\/p>\r\n

\u00a015 (3.77%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Tension prevented me from performing well<\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

\u00a0\u00a0 \u00a0 Strongly agree\/Agree\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0\u00a0Neutral\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0\u00a0Disagree\/Strongly disagree<\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

229 (57.68%)<\/span><\/span><\/p>\r\n

101 (25.4 %)<\/span><\/span><\/p>\r\n

\u00a0\u00a067 (16.87%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Internet\/gadget prevented me from performing well\u00a0<\/span><\/span><\/p>\r\n<\/td>\r\n

<\/td>\r\n<\/tr>\r\n
\r\n

\u00a0 \u00a0 \u00a0 Strongly agree\/Agree<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Neutral\u00a0<\/span><\/span><\/p>\r\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Disagree\/Strongly disagree\u00a0<\/span><\/span><\/p>\r\n<\/td>\r\n

\r\n

129 (32.49%)<\/span><\/span><\/p>\r\n

94 (23.7 %)<\/span><\/span><\/p>\r\n

174 (43.83%)<\/span><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

Table 1. Post-VOSCE Survey<\/span> n= 397<\/span><\/span><\/p>\r\n

<\/span>IV. DISCUSSION<\/span><\/strong><\/p>\r\n

Participants orientation and the simulation were important in\u00a0ensuring the success of this VOSCE. The students perceived that SGDs 319 (80.3 %), Canvas rubrics 335 (84.4%), and orientation 336 (84.63%), helped in their preparation.\u00a0However, the students viewed that tension 129 (32.49%) and internet and gadget issues 229 (57.68 %) prevented them from performing well. <\/span>\u00a0<\/span><\/p>\r\n

P<\/span>assing <\/span>rates were comparable, with OSCE 75.68 % <\/span>and <\/span>VOSCE <\/span>78.9 %. Moreover, the mean score of the VOSCE 8<\/span>1, <\/span>was only slightly lower than OSCE mean, 82.07.\u00a0<\/span>\u00a0<\/span><\/p>\r\n

With ease of restrictions the following year, we continued using VOSCE <\/span>because <\/span>we obtained<\/span> similar results to OSCE, it was less costly and easier to manage.\u00a0 Post-pandemic it will remain an important tool for formative and summative assessments. Among its advantages, there are examiners\/faculty available for the VOSCE because it is online. Furthermore, it can be modified to administer some stations online, while conducting the PE stations onsite. <\/span>\u00a0<\/span><\/p>\r\n

<\/span>V. CONCLUSION<\/span><\/strong><\/p>\r\n

We have demonstrated that the VOSCE may be given <\/span>successfully and will continue to play<\/span> an important role in <\/span>assessment<\/span> post-pandemic. It is more convenient and economical to administer. Its main d<\/span>isadvantages<\/span> <\/span>include<\/span> the possibility of internet disruption and gadget malfunction. However, with planning, innovation, orientation, and communication, it may be administered with<\/span>out major<\/span> problems. <\/span>It<\/span> is reassuring th<\/span>at w<\/span>hatever restrictions we <\/span>may <\/span>face in the future, the VOSCE,\u00a0will <\/span>ensure we can continue to pr<\/span>oduc<\/span>e competent<\/span> doctors<\/span>,<\/span> who will be part of the solution to the healthcare problems of the world.<\/span>\u00a0<\/span><\/p>\r\n

Notes on Contributors<\/span><\/strong><\/p>\r\n

The author did the literature review, conceptualised and oversaw the implementation of the VOSCE, created the post exam survey, retrieved previous grades pre-pandemic, analysed the data and wrote the manuscript. <\/span>\u00a0<\/span><\/p>\r\n

Acknowledgement<\/span><\/strong><\/p>\r\n

The author would like to acknowledge the administration and the faculty of the Department of Obstetrics and Gynaecology of the University of the East Ramon Magsaysay Memorial Medical Centre, for their trust and support in the planning and conduction of the VOSCE. Special thanks to the<\/span> r<\/span>esident<\/span>s<\/span> who helped to orient the participants, monitored, and helped in running Canvas and Zoom. The author would also like to extend her gratitude to the clinical clerks and the postgraduate interns, who have given their time during the technical dry run and for serving as standardised patients during the conduct of the VOSCE. <\/span>\u00a0<\/span><\/p>\r\n

Funding<\/span><\/strong><\/p>\r\n

The author did not receive any funding for this study. <\/span><\/p>\r\n

Declaration of Interest<\/span><\/strong><\/p>\r\n

The author does not have any conflict of interest. <\/span><\/p>\r\n

References<\/span><\/strong><\/p>\r\n

Boyle, <\/span>J. G., <\/span>Colquhoun<\/span>, I.<\/span>,<\/span> <\/span>Noonan,<\/span> Z., <\/span>McDowall, <\/span>S., <\/span>Walters<\/span>, M. R., &<\/span> Leach<\/span>, J. P.<\/span> <\/span>(2020)<\/span>.<\/span> Viva la VOSCE?<\/span> <\/span>BMC Medical Education,<\/span><\/i> 20<\/i>(1). Article 514. <\/span>https:\/\/doi.org\/10.1186\/s12909-020-02444-3<\/span><\/a><\/span> <\/span><\/p>\r\n

Department of Education. (2020, December). Official statement on the pilot implementation of limited face-to-face classes.<\/i> <\/span>Retrieved July 20, 2021, from <\/span>https:\/\/www.deped.gov.ph\/2020\/12\/15\/official-statement-on-the-pilot-implementation-of-limited-face-to-face-classes\/<\/span><\/a><\/span><\/span><\/p>\r\n

Lara, S., Foster, C. W., Hawks, M., & Montgomery, M. (2020). Remote assessment of clinical skills during COVID-19: A virtual, high-stakes, summative pediatric objective structured clinical examination.\u00a0Academic Pediatrics, 20<\/i>(6), 760-761. <\/span>https:\/\/doi.org\/10.1016\/j.acap.2020.05.029\u00a0<\/span><\/a><\/span><\/span><\/p>\r\n

Livingston, S. A., & Zieky, M. J. (1982). Passing scores: A manual for setting standards of performance on educational and occupational tests.<\/i> Educational Testing Service.<\/i><\/span><\/p>\r\n

Nguyen, L., Tardioli, K., Roberts, M., & Watterson, J. (2015). Development and incorporation of hybrid simulation OSCE into in-training examinations to assess multiple CanMEDS competencies in urologic trainees.\u00a0Canadian Urological Association Journal, 9<\/i>(1-2), 32. <\/span>https:\/\/doi.org\/10.5489\/cuaj.2366\u00a0<\/span><\/a><\/span><\/p>\r\n

*Teresa Diana B. Bongala<\/span>
\r\n<\/span><\/span>64 Aurora Boulevard,<\/span>
\r\nQuezon City, Metro Manila,
\r\nPhilippines
\r\n+639175776420
\r\nEmail: tbbongala@uerm.edu.ph
\r\n<\/span><\/span><\/span><\/p>\r\n<\/div>","protected":false},"featured_media":0,"parent":0,"menu_order":8,"template":"","issues_category":[18],"archive_category":[],"issue_type":[25],"volume_category":[61875],"class_list":["post-71959","issues","type-issues","status-publish","hentry","issues_category-case-study","issue_type-past-issue","volume_category-volume-8-number-1-january-2023"],"acf":[],"yoast_head":"\nConducting a large-scale summative Virtual OSCE (VOSCE) in a University Medical Centre during the COVID-19 pandemic - The Asia Pacific Scholar<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/taps\/issues\/conducting-a-large-scale-summative-virtual-osce-vosce-in-a-university-medical-centre-during-the-covid-19-pandemic\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Conducting a large-scale summative Virtual OSCE (VOSCE) in a University Medical Centre during the COVID-19 pandemic - The Asia Pacific Scholar\" \/>\n<meta property=\"og:description\" content=\"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. 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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. 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