Development and Evaluation of an Online Exam for Exercise Physiology During the COVID-19 Pandemic

Abstract

ABSTRACT Background The COVID-19 pandemic necessitated substantial changes to university learning and teaching, notably conversion to online formats. Physical interaction is inherent in an exercise physiology curriculum, but it is unclear whether students' clinical skills can be adequately assessed online. This study describes the development of an online Objective Structured Clinical Examination (OSCE) and aimed to determine its appropriateness for assessing final year undergraduate exercise physiology students' clinical skills. Methods We converted our face-to-face (f2f) OSCE to an online format. This required station adaptation (e.g., editing scenarios to suit a telehealth format), technological considerations (for students, clients, and examiners), personnel and procedural aspects, and pilot testing. Fifteen students completed the online OSCE which was performed in May 2020. All OSCE stations were recorded, then later observed by 4 experienced OSCE examiners who appraised whether online OSCE features were better, worse, or similar to f2f for fairly and accurately assessing student performance across multiple domains (i.e., communication, information technology, procedural and technical components, professionalism, quality of assessment, and risks). Results Of 3,540 responses, 2,846 (80.4%) indicated no difference in quality between the f2f and online OSCEs (P < 0.001). Of the remaining 694 responses, 654 (94.4%) indicated that the online OSCE was worse than f2f (P < 0.001), most notably in the risk domain. Conclusion The online OSCE was a sufficiently accurate and authentic clinical skills assessment for exercise physiology students. With ongoing challenges with clinical assessment posed by COVID-19 and telehealth likely to continue, the online format appears a suitable alternative and could be used to assess students online.