The methods in this study were performed following the STROBE guidelines for reporting observational studies, which include a checklist for cross-sectional studies [13].
Workshops
The national OSCE teaching was delivered as a series of online workshops delivered on a weekly basis via ZoomⓇ (Zoom Video Communications, USA), from February to March 2021 as a nationally organised student-led initiative. It was identified that there was a deficit in the availability of online structured OSCE teaching that supported the student experience with both practice and detailed feedback. Therefore, launching an OSCE workshop series was an appropriate medium to widen accessibility and utility to improve clinical practice. The sessions focused on practising common OSCE stations, including history-taking, communication and data interpretation skills. Sessions were delivered for each of the commonly examined specialities: cardiology, respiratory, gastroenterology, neurology and endocrinology.
In total, the series was composed of five consecutive workshops, attended by 85 students distributed throughout. Each session had a total of six OSCE stations and consisted of two circuits with three stations per circuit. A single circuit composed of one history-taking station, one communication station and one data interpretation station, each of which was overseen by an assigned examiner. The examiners were clinical-year medical students at various medical schools across the UK and they led, facilitated and delivered feedback for their assigned station. The maximum number of students in each session was limited to 36 in order to ensure that the examiners were able to provide detailed and individualised feedback within the allocated time. The students signed up for the workshops via an online application form and were allocated to each session on a first come, first served basis.
The format remained the same for both the history-taking and communication stations. Resources were prepared in advance by the examiners and students were assigned pairs within their groups of six; each pair then took it in turn to practice a scenario. One student would take on the role of the patient while the other would serve as the active participant. The role of the student would alternate between the communication and history-taking stations, thereby giving students the opportunity to both practice skills and contribute to the feedback for their peers. Simultaneously, the examiners would review participant performance during the stations and provide individualised feedback, thereby opening space for reflection. At the end of each session, the examiners would collectively go over the predesigned mark scheme with each group of six with the aim of exploring how to approach a similar station. The data interpretation station was delivered in a group-teaching format, whereby the examiners discussed scenarios with the students and offered methods, advice and tips on tackling a similar station in the exam.
Student feedback
At the end of each workshop, each of the students was given a feedback questionnaire which asked them, in the form of comparative statements, to state how strongly they agreed with the following: online OSCE teaching is as interactive, as engaging, as useful in enabling to them develop relevant clinical skills and providing constructive and helpful feedback. The questionnaire also asked the students to rank their confidence in history-taking, communication and data interpretation for that specialty before and after the session, which was graded on a 5-point Likert scale where 1 = not confident at all and 5 = very confident. A Likert scale was chosen to quantify students’ perceived confidence. Importantly, students were also asked whether they that online OSCE sessions would be useful in the post-pandemic phase.
Examiner feedback
The examiners were given similar questionnaires asking them to state how strongly they agreed or disagreed with the same comparative statements regarding online and in-person OSCE teaching, and whether they felt that online-based OSCE teaching would be useful for learning after the pandemic.
Statistical methods
Attendees completed post-workshop questionnaires and data was collected regarding the demographics of the students and feedback of the workshops. Five-point Likert scales were used to quantify the qualitative opinions and perceptions of students and examiners. The Shapiro-Wilk test was used to assess whether the data was normally distributed, and the Mann-Whitney U test was used to assess statistical differences between nonparametric pre- and post-event responses.
Ethics
This study involved no patients and consisted entirely of both preclinical and clinical medical students attending an undergraduate student-led workshop, requiring no medical or personal information. All participants in this study gave approval for their anonymous data to be used towards potential future research.