Student and Tutor Satisfaction with an Online and Paper-based Clinical Assessment Tool. (Preprint)

Abstract

Assessment of students’ clinical competence in healthcare education typically involves the evaluation of their performance during a patient consultation. Direct observation of students with actual patients is important for the assessment of clinical skills prior to professional registration. The mini-clinical evaluation exercise (mini-CEX) has been widely established as part of a broad clinical assessment profile. The paper form has previously been validated in a number of healthcare scenarios including pre-registration osteopathic practice. Differences in satisfaction, when deploying the instrument through different media, are not widely explored.

This study explored osteopathy students’ and tutors’ rating of satisfaction using the mini-CEX when administered via online and paper-based media. This was with a view to answer the following research question: Does the method of capture influence assessment satisfaction scores in the use of the mini-CEX?

An online mini-CEX was developed using Google Forms and was initially trialled as a data entry process, with administration staff keying-in the completed paper assessment details post-hoc. Subsequently, Android-based tablets were used for direct capture of the observed clinical practice evaluation of students by tutors. This facilitated a comparison to the paper counterpart over the course of three academic years. The influence of gender and methods of assessment capture (paper and online) was explored with binary regression, Spearman's correlation and Kruskal Wallis test, with dependent variables of student and tutor satisfaction.

A total of 736 mini-CEX assessments of patient encounters were analysed, and 550 (75%) were completed online. The influence of the paper capture of assessment on satisfaction scores, compared to the online process, was not significant (odds ratio 1, CI 0.86 – 1.15). Student satisfaction ratings for female students assessed by male tutors indicated lower summary scores compared to same-sex pairings (P<.007). Correlation between all student and tutor satisfaction ratings was moderate (r2=0.62, 95% CI 0.57 – 0.66, P<.00001).

The findings suggest that there is no statistically significant difference between the two methods of delivery in terms of satisfaction of use for either examiner or student, potentially indicative of the suitability of the online version. While this has relevance to the teaching environment within osteopathy, there is applicability to other clinical healthcare. The role of gender as an influence in the satisfactory conduct of assessment warrants further investigation

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