Remote Clinical Skills Assessment for Medical Professional Examinations: During and Beyond the Pandemic

To overcome the challenges of the COVID19 pandemic, we developed a remotely-delivered, online clinical skills examination using purpose-built software. Here we outline and evaluate the reliability and validity of the exam and consider its application beyond the pandemic. Building on an existing digital scoring and virtual assessment software, Qpercom developed a new tool with input and repeated pilot testing by our academic and administrative examinations team. This tool also had additional features allowing for reliable (a) video -conferencing virtual examination rooms, (b) automatic control of the rotation of candidates across virtual rooms (c) a ‘control room’ for exam administration and (d) real time display of examination cards with physical examination and investigation findings. The new tool was used over three examination diets and the validity and reliability of the resultant examinations were assessed. The validity and reliability of the remote exams were not significantly different to those of face-to-face assessments. Content validity, was very similar with the exception of the inability to test physical examination. Regarding reliability, low Cronbach’s alpha values were observed for some remote examinations when variability between student marks was also low explaining these alpha values. However, Standard error of Measurement (SEM) estimates, which are more reliable in the setting of small numbers examinations such as the ones described here, compared favourably to previous face to face examinations. Thus, remote, online delivery of clinical skills examinations using purpose-built software is feasible, valid and reliable and may represent a favourable option beyond the pandemic.