Using Virtual Learning Environments to Improve the Quality and Availability of Clinical Examination Education for Medical Students

Background The COVID-19 pandemic posed an existential challenge on medical education (Ferrel & Ryan, 2020; Sahi et al., 2020). Complete removal of medical students from clinical rotations and limitations on physical interactions drastically affected the in-person learning opportunities available and demanded innovation toward online education. Though COVID-19 restrictions have eased, limitations on in-person teaching will persist due to infection control measures, logistical difficulties, and with the expectation of other epidemics in the future (Marani et al., 2021). OSCE (Observed Structured Clinical Examination) Prep UK developed a virtual learning environment to characterise and mitigate the disruptive impact that the COVID-19 pandemic caused to medical education. The overarching goal was to provide an accessible, reproducible, and scalable platform to aid and enhance future medical student learning. Aim To assess and mitigate negative disruptions in undergraduate medical education caused by COVID-19, through a data driven interactive virtual learning environment. Methods Medical students completed online questionnaires detailing COVID-19 related training disruption. 29 hour-long interactive system-specific clinical examination tutorials were delivered with accompanying asynchronous online content. Pre-and-post session questionnaires assessed quantitative changes in knowledge and confidence, and qualitative perceptions of the value of the materials. Results 1693 participants completed the COVID-19 survey. >75% described reduced patient contact, bedside teaching, and clinical skills training. 69% reported university teaching gaps. <20% were satisfied with clinical skills training. <35% felt competent performing expected clinical examinations. >85% desired supplemental teaching. Over 689 attendances, >95% of participants, agreed that sessions: enhanced locally organised teaching; led to achieved learning outcomes and were relevant to their curriculum. Median increases in knowledge and confidence scores were 25% (IQR:0-60%, p<0.01) and 43% (IQR:23-81%, p<0.01) respectively. Discussion Medical students reported significant medical education disruptions and shortfalls due to COVID-19. OSCE Prep UK’s virtual learning environment was highly valued, in great demand and demonstrated significant improvements in student knowledge and confidence. This extremely scalable and reproducible educational model can continue to improve accessibility, efficiency, and efficacy of undergraduate medical education, particularly when physical resources are limited.