A validated Virtual OSCE (vOSCE) for assessing clinical competence in family medicine residents: a multicenter study

Background Competency-based medical education (CBME) demands robust assessment tools capable of evaluating clinical performance across multiple domains. The virtual Objective Structured Clinical Examination (vOSCE) has emerged as a valid and scalable alternative to the traditional in-person format, particularly relevant in Latin American postgraduate training contexts where logistical and resource constraints often limit large-scale assessments. This study aimed to evaluate clinical competence in third-year family medicine residents at the Mexican Social Security Institute (IMSS) using a vOSCE. Methods This multicenter observational study was conducted in three phases. A vOSCE administered via Zoom™ was developed and validated in 64 third-year family medicine residents from five IMSS training sites in Veracruz and Mexico City during 2024–2025. The assessment comprised three clinical stations—type 2 diabetes mellitus, arterial hypertension, and depression—developed by a seven-member expert committee in accordance with AMEE Guide No. 81. Content validity was established through a two-round Delphi process involving six experts. The analytical rubric included eight items per station rated on a four-level Likert-type scale. Reliability was assessed using Cronbach’s alpha, and construct validity was evaluated through exploratory factor analysis with Varimax rotation. Evaluators were trained, standardized, and cross-assigned to ensure impartiality. Results The global weighted mean score across all three stations was 8.77 out of 10. Between 89.1% and 96.9% of residents achieved “Good” or “Outstanding” performance levels depending on the station. Diagnostic skills, clinical history-taking, and verbal and non-verbal communication consistently obtained the highest scores (median: 10) in the DM2 and Hypertension stations. The approach to protective factors was the lowest-scoring attribute across all three stations (median: 5.0 in DM2; 7.5 in Hypertension and Depression), representing gap in preventive competencies. Residents’ self-assessed performance (median: 9.0/10) was congruent with externally measured scores, suggesting adequate clinical metacognition. Conclusions This multicentric experience supports the validity and scalability of vOSCE as a competency assessment strategy in residency programs and contributes to the growing evidence base for virtual clinical examination in Latin American postgraduate medical education.