Exploring stakeholder perceptions on the integration of virtual reality into Objective Structured Clinical Exams (OSCEs): A qualitative study

Background: Virtual Reality (VR) is already used for training in medical education and is increasingly being explored as an assessment tool. However, little is known about how stakeholders of these assessments, such as Objective Structured Clinical Exams (OSCEs), perceive the integration of VR into OSCEs. Therefore, we aimed to explore the perceptions of the stakeholders, i.e., students, examiners, and method experts, and what they consider necessary for successful integration. Methods: In this qualitative study, we interviewed 33 medical students, 7 examiners, and 7 method experts. We transcribed all the interviews and analyzed them using reflexive thematic analysis. Results: We developed 4 themes out of the generated data: The first theme, promising, but not ready for takeoff , captures the view of participants that VR holds potential, but is not yet ready for large scale implementation in summative assessments. The second theme, e mbedding VR within a broader educational strategy emphasizes the importance of introducing VR into the curriculum early on and ensuring it is only used for learning objectives that can meaningfully be assessed through VR. Third, keeping the human in the loop emphasizes the importance of the human element which should not be underestimated when assessing clinical skills. Finally, misunderstanding of VR highlights that the capabilities of VR were often unknown. Conclusions: VR seems to have potential as a future assessment tool, especially if certain conditions are met, above all that it is guided by pedagogical principles and aligned with meaningful learning objectives rather than being driven solely by technology.