Letter to Editor: Recommendations for safer management of holding OSCE during COVID-19 outbreak.

Letter to editor,

Coronavirus disease 2019 (COVID-19) is the third coronavirus that has emerged in the past 2 decades, causing a path in making practical changes in medical education. Educational planners and teachers are confronted with different educational challenges, including canceling all face-to-face sessions, postponing exams, and delaying educational activities in clinical settings. Moreover, conducting high stake assessments such as objective structured clinical examination (OSCE) is difficult during different phases of curriculum (1, 2). The OSCE is one of the popular clinical skills examinations and has been used for residents and medical students’ assessment across a broad range of medical disciplines (3-5). During the COVID-19 pandemic, we are faced with many obstacles for minimizing risks and protecting the safety of medical students, faculties, standardized patients (SPs) and personnel for planning and conducting OSCE. Based on our experiences in the Clinical Skills Center at Tehran University of Medical Sciences (TUMS), some recommendations for conducting OSCE in safer exam settings during the COVID-19 outbreak are presented:

Setting up OSCE with minimum but standard stations.

Limit the number of participants and students as much as possible without any group gathering.

Allocating a place for registration at entrance, preferably outside the building.

Body temperature screening and taking brief history, on arrival, about encountering patients, family members or friends with COVID-19 or travel in the last weeks

Designing and implementing the exam in the Clinical Skills Center instead of hospitals or clinics.

Sharing the instruction and map of the building a day before by social media for facilitating access.

Preparing all protections for safety such as sanitizers, masks, gowns, gloves, and face-shields for all participants, personnel, SPs, and faculties.

Performing social distancing in each part of OSCE and choosing larger rooms (6 feet apart except for physical examination)

Cleaning all equipment and manikins after each stop in the stations.

Using manikins and simulators for assessing physical exam skills of students instead of SPs as much as possible

Using a hand sanitizer before and after each station.

Placing air condition with enough negative pressure in the stations and rooms

Using cascade method instead of circuit for less contact between participants

Using video conference instead of physical attendance for standard patients when possible in the history taking stations.

Using digital scoring instead of paper-based questionnaire methods.

Using high quality cameras to record student performance at stations and score live or for subsequent evaluations by evaluators.

As we navigate through this crisis, seeking ways to enhance our teaching and assessment experience while preserving the routine that we have already established with our students is necessary. We hope the recommendations provided can help make OSCE tests safer in the event of a Covid-19 pandemic.

Conflict of Interests

The authors declare that they have no competing interests.