Asmar Nadia, Youssef Nazih Y, Malhab Sandrella Bou, Bahous Sola, Karam Vanda G Yazbeck
Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University (LAU), Byblos, Lebanon.
Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon.
BMC Med Educ. 2025 Jun 5;25(1):841. doi: 10.1186/s12909-025-07383-5.
The COVID-19 pandemic posed significant challenges to medical education, requiring adaptations in assessment methodologies to maintain academic rigor and safety. Traditional in-person Objective Structured Clinical Examinations (OSCEs) posed challenges due to social distancing requirements, leading to the emergence of virtual OSCEs as viable alternatives. This study evaluates the construct validity of a virtual OSCE with a focus on its applicability during extraordinary circumstances.
The study involved 27 third-year medical students participating in a virtual OSCE comprising seven stations, each designed to assess critical clinical competencies such as history-taking, differential diagnosis, and communication skills. The OSCE's validity was assessed across four dimensions: content, response process, internal structure, and consequences, using psychometric and qualitative analyses.
Content validity was ensured through alignment with a predefined blueprint and expert review of clinical scenarios. The response process was supported by comprehensive training for faculty and simulated patients (SPs), contributing to consistent scoring and comfort with the virtual format. Psychometric analysis showed a Cronbach's alpha of 0.67 across stations, indicating acceptable internal consistency. Consequential validity, assessed via the Borderline Regression Method (BRM) for setting cut-scores, highlighted fair and defensible decision-making. Despite technical challenges, no students failed the OSCE or their clerkship.
The virtual OSCE has proven to be a valid, reliable, and feasible tool for assessing clinical competencies. Virtual OSCEs offer a scalable solution to sustain medical education continuity in resource-limited and geographically dispersed settings, paving the way for advancements in global competency-based assessments.
新冠疫情给医学教育带来了重大挑战，需要调整评估方法以维持学术严谨性和安全性。由于社交距离要求，传统的面对面客观结构化临床考试（OSCE）面临挑战，这导致虚拟OSCE作为可行的替代方案出现。本研究评估了虚拟OSCE的结构效度，重点关注其在特殊情况下的适用性。
该研究纳入了27名三年级医学生，他们参加了一个包含七个站点的虚拟OSCE，每个站点旨在评估关键的临床能力，如病史采集、鉴别诊断和沟通技巧。使用心理测量和定性分析，从内容、反应过程、内部结构和后果四个维度评估了OSCE的效度。
通过与预定义蓝图保持一致以及对临床场景进行专家评审，确保了内容效度。对教员和模拟患者（SP）进行的全面培训支持了反应过程，有助于一致评分以及对虚拟形式感到舒适。心理测量分析显示各站点的Cronbach's alpha为0.67，表明内部一致性可接受。通过用于设定及格分数的边界回归方法（BRM）评估的结果效度突出了公平且合理的决策。尽管存在技术挑战，但没有学生在OSCE或其临床实习中不及格。
虚拟OSCE已被证明是评估临床能力的有效、可靠且可行的工具。虚拟OSCE提供了一种可扩展的解决方案，以在资源有限和地理分散的环境中维持医学教育的连续性，为全球基于能力的评估的进步铺平了道路。
