Letter for the article Changing student perception of an online integr

Mr. editor

We read with interest the article by Ganesananthan et al regarding the perception of integrated structured clinical examinations online among students.1 The authors highlighted the benefits of using online reviews given the ongoing COVID-19 pandemic and how peer-led simulations can improve confidence in these reviews. As final year medical students, we were interested in the similarities and differences we experienced over the past year and would like to offer our perspectives.

Peer-led education and mock exams offer a huge advantage to medical education, often filling gaps that formal education does not cover. In addition to familiarization and practice with the new material, they are a good opportunity for feedback and improvement. Our experience with similar programs in our medical school is equally positive, but the low stakes translate into more generous feedback compared to the high stakes summative reviews where you are rated competitively against your peers. Therefore, we found that the measures used in the study did not include other commonly cited factors that affect confidence in online summative reviews, such as the risk and ease of cheating compared to in-person reviews. .2.3 It would have been interesting to read the cohort’s confidence in online exams regarding these factors, as well as a comparison of attitudes after official exams and the poll of the remaining 58.4% of the cohort who did not. have not responded.

While online exams may have been a necessity earlier in the pandemic, the lack of in-person final exams for graduate students in 2020 has been cited to impact preparation to begin their first year of basic training. because online exams do not provide a proper assessment of essential practical skills in medicine.4 At our facility, the 2021 cohort was scheduled to pass the finals ahead of the second wave of COVID-19 in the UK. Alternatives such as adapted objective clinical examinations (OSCEs) or an online ECO have been suggested. Ultimately, the finalists were assessed by a “workplace clinical examination” both in the community and in a hospital setting. Students were assigned to a patient and an examiner in either setting to take a complete history, perform any necessary exams the student deemed fit for 20-30 minutes, followed by a discussion of 10 to 15 minutes with the examiner regarding the diagnosis and management. Years three and four had changed the OSCEs later in the year, with three days of three-station tours wearing full PPE rather than two days of seven stations. These changes have allowed us to maintain the benefits of in-person assessments, while maintaining a high level of safety for simulated patients, staff and students.

In conclusion, Ganesananthan et al show that peer-led simulations can help improve confidence in online OSCE among students engaged in extracurricular activities. However, it would be beneficial to have included a wider range of students in their cohort, to have included a wider range of questions regarding trust in online exams, and to have interviewed respondents after their exams. formal exams. Or in light of the in-person alternatives, student reflections on these OSCEs versus online OSCEs as complements to existing assessments.


The authors do not point out any conflicts of interest in this communication.

The references

1. Ganesananthan S, Li C, Donnir A, et al. Changing Student Perception of an Online Integrated Structured Clinical Exam during the COVID-19 Pandemic. Adv Med Educ Pract. 2021; 12: 887-894. doi: 10.2147 / AMEP.S325364

2. Elsalem L, Al-Azzam N, Jum’ah AA, Obeidat N, Sindiani AM, Kheirallah KA. Stress and Behavioral Changes with Remote Electronic Examinations During the Covid-19 Pandemic: A Cross-sectional Study Among Undergraduate Medical Science Students. Ann Med Surg. 2020; 60: 271-279. doi: 10.1016 / j.amsu.200.10.058

3. Khalaf K, El-Kishawi M, Moufti MA, Al Kawas S. Presenting a comprehensive, high-stakes online exam to final year dental students during the COVID-19 pandemic and evaluating its effectiveness. Med Educ Online. 2020; 25 (1): 1826861. doi: 10.1080 / 10872981.2020.1826861

4. Choi B, Jegatheeswaran L, Minocha A, Alhilani M, Nakhoul M, Mutengesa E. The impact of the COVID-19 pandemic on final year medical students in the UK: a national survey. BMC Med Educ. 2020; 20 (1): 206. doi: 10.1186 / s12909-020-02117-1

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