Evaluation of a virtual objective structured clinical examination in the metaverse (Second Life) to assess the clinical skills in emergency radiology of medical students in Spain: a cross-sectional study.

Purpose: The objective structured clinical examination (OSCE) is an effective but resource-intensive tool for assessing clinical competence. This study hypothesized that implementing a virtual OSCE in the Second Life (SL) platform in the metaverse as a cost-effective alternative will effectively assess and enhance clinical skills in emergency radiology while being feasible and well-received. The aim was to evaluate a virtual radiology OSCE in SL as a formative assessment, focusing on feasibility, educational impact, and students' perceptions.

Methods: Two virtual 6-station OSCE rooms dedicated to emergency radiology were developed in SL. Sixth-year medical students completed the OSCE during a 1-hour session in 2022-2023, followed by feedback including a correction checklist, individual scores, and group comparisons. Students completed a questionnaire with Likert-scale questions, a 10-point rating, and open-ended comments. Quantitative data were analyzed using the Student t-test and the Mann-Whitney U test, and qualitative data through thematic analysis.

Results: In total, 163 students participated, achieving mean scores of 5.1±1.4 and 4.9±1.3 (out of 10) in the 2 virtual OSCE rooms, respectively (P=0.287). One hundred seventeen students evaluated the OSCE, praising the teaching staff (9.3±1.0), project organization (8.8±1.2), OSCE environment (8.7±1.5), training usefulness (8.6±1.5), and formative self-assessment (8.5±1.4). Likert-scale questions and students' open-ended comments highlighted the virtual environment's attractiveness, case selection, self-evaluation usefulness, project excellence, and training impact. Technical difficulties were reported by 13 students (8%).

Conclusion: This study demonstrated the feasibility of incorporating formative OSCEs in SL as a useful teaching tool for undergraduate radiology education, which was cost-effective and highly valued by students.