Evaluating construct validity of virtual osces in exceptional conditions.

Background: The COVID-19 pandemic posed significant challenges to medical education, requiring adaptations in assessment methodologies to maintain academic rigor and safety. Traditional in-person Objective Structured Clinical Examinations (OSCEs) posed challenges due to social distancing requirements, leading to the emergence of virtual OSCEs as viable alternatives. This study evaluates the construct validity of a virtual OSCE with a focus on its applicability during extraordinary circumstances.

Methods: The study involved 27 third-year medical students participating in a virtual OSCE comprising seven stations, each designed to assess critical clinical competencies such as history-taking, differential diagnosis, and communication skills. The OSCE's validity was assessed across four dimensions: content, response process, internal structure, and consequences, using psychometric and qualitative analyses.

Results: Content validity was ensured through alignment with a predefined blueprint and expert review of clinical scenarios. The response process was supported by comprehensive training for faculty and simulated patients (SPs), contributing to consistent scoring and comfort with the virtual format. Psychometric analysis showed a Cronbach's alpha of 0.67 across stations, indicating acceptable internal consistency. Consequential validity, assessed via the Borderline Regression Method (BRM) for setting cut-scores, highlighted fair and defensible decision-making. Despite technical challenges, no students failed the OSCE or their clerkship.

Conclusion: The virtual OSCE has proven to be a valid, reliable, and feasible tool for assessing clinical competencies. Virtual OSCEs offer a scalable solution to sustain medical education continuity in resource-limited and geographically dispersed settings, paving the way for advancements in global competency-based assessments.