A Response to “We Need More Practice”: Evaluating the Role of Virtual Mock OSCES in the Undergraduate Programme During the COVID Pandemic [Response To Letter]

Dear editor

I would like to thank Miss Kelly and Mr Lam for their correspondence.

Both of the points raised in relation to mimicking the summative environment and assessing anxiety levels are extremely important and were recognised by the authors.

Although attempts were made to replicate the summative environment, the authors were constrained by the resources available. As acknowledged in the paper, clinical skills were not assessed and these form a component of the 10minute station on Day 2 of their summative examinations. Interestingly, the limitations of virtual OSCEs have been acknowledged in a recent meta-analysis¹ and exploring the suitability of such sessions for testing clinical or operational skills is an area that requires further research. Identifying exactly how, and, if these skills can be assessed in the virtual environment is tricky, especially with the high number of students being assessed (354 students participated in this study), as it requires each student to have access to appropriate materials. It is also important to note that students are assessed on eight 5minute stations on Day 1 of their summative examinations and so having 5minute stations as part of the virtual mock OSCE session was representative of an element of the summative OSCEs.

We were also constrained by the number of examiners available and therefore adjustments had to be made, especially for Day 2 of the virtual mock OSCEs whereby students also acted as the examiner. We acknowledge that this was not ideal but it was felt that this approach was more suitable than cancelling the entire session. Although we appreciate this limited the opportunity to practice, it did enable peer review and this has been acknowledged as an important factor for enabling skills development in the literature.²

The authors acknowledge that assessing anxiety levels before and after the OSCEs may have provided further insight. However, the findings in this study are not unique, as they rely on student’s self-reported measures of confidence levels and inconsistent results have similarly been demonstrated in studies analysing student confidence levels pre- and post- “in-person” mock OSCEs.³

Finally, while the authors believe that virtual mock OSCEs provide an alternative platform that can be easily accessed for students to develop their skills, it cannot fully replicate the “in-person” experience. Identifying how virtual mock OSCEs can therefore be optimised to support students is vital, especially with the move towards telehealth.