We implemented a virtual teleneurology objective structured clinical examination (OSCE) during the pandemic to minimize resident education disruption.

Simulation is a well-established tool in graduate medical education to develop and strengthen trainees’ skills.  Lack of access to a simulation center or unpredictable circumstances such as a pandemic can limit the utilization of this effective evidence-based teaching modality.

The virtual OSCE was created by modifying an existing OSCE that was conducted in our simulation center with first-year neurology trainees (N=13).  Trainees conducted a 15-minute televisit with an SP presenting with signs and symptoms consistent with meralgia paresthetica.  Pertinent history was provided beforehand with instructions to perform an examination and formulate an assessment and plan.  The encounter was observed by a faculty member who provided written and oral feedback.  During the virtual simulation the standardized patient (SP), faculty observer and second- and third-year neurology trainees (N=34) accessed the OSCE using their own devices at locations of their choosing.  A faculty member played the SP instead of an actor from the simulation center. 

After the remote simulation residents’ comfort level with televisits increased from 3.4 to 4.3 (scale 1-5) (P<0.05), similar to on-site simulation survey results (2.8 to 3.8, P<0.05).  Residents rated the remote simulation as useful (4.3), educational (4.3), and 88% thought it should be repeated in the future, 12% said maybe, 0% said no.  This was similar to on-site OSCE evaluations (4.8, 4.8 and 100%, respectively).  Faculty feedback was also comparable.

Remote simulations can provide equivalent educational benefits to on-site simulations with unique additional benefits.  Remote simulations minimize scheduling conflicts since trainees do not need to be pulled from rotations for prolonged periods.  Expanding the use of remote simulations may especially enhance trainee education in programs that do not have access to a simulation center.