PG30 How to do a remote OSCE successfully: converting face to face simulation into a Virtual E-consult in the pandemic crisis

Abstract

Introduction The COVID-19 pandemic presented an opportunity in our undergraduate year1 nursing degree program to innovate. We redesigned a face-to-face OSCE into an E-consult OSCE involving simulated patients (SPs), scenarios and video conference communication, recreating a live meaningful simulation assessment. Our priority was to develop a virtual simulation assessment recreating the relational process of professional care. Students could actively demonstrate the phenomenologically important skills of active listening, empathy, bracketing, and engagement in dialogue in the patient lived-experience. Summary of Innovation The authors, students (150 in total), SP provider and SPs collaboratively crafted this innovation. A ‘People, Process and Tools’ approach (figure 1) to assist us with adapting to the change of space and engagement. For students and academics, marking had changed from paper (pre-COVID-19) to contemporaneous electronic google form marking. SPs, following a standardised scenario, provided the behavioural clues of illness in line with the A to E-assessment. Philosophical principles of relational existentialism were our underpinning concepts -what it means to be human– we believed this could be assessed virtually. Students were expected to use E-consult concepts, demonstrate the professional clinical ability to take a health history from an SP, conduct an A to E assessment and ‘connect’ with the SP (as advocates of ‘real’ patients). Summary of Results Over 4 days, we successfully conducted the E-consult OSCE (150 students). The academic team provided support to the students in both their educational programme preparing them for the assessments; and in examining. There was a similarity of in pass rate: 90% -online OSCE cohort and 82% -preCOVID-19 standard OSCE cohort. Feedback from students showed that they utilized and focused on underpinning knowledge whilst drawing on previous simulation learning to respond to the patient. Conducting an E-consult enhanced the student experience. Discussion Planning, organisation, consistency, and communication were key. The cohesive mutuality and trust of the team (academics, IT, SPs) alongside individual leadership held the process on track; ‘Adapt and overcome’ became our motto. The gestalt principles of collective ability and focus to achieve a goal in the face of the challenge were modelled. Areas to consider: Support systems infrastructure for mass virtual assessment Scenario specificity e.g. frequency/type of behavioural clues SP & staff fatigue References NHS Long term Plan ( 2019). https://www.longtermplan.nhs.uk/online-version/