Objective Structured Clinical Exam Research Articles

A competency roadmap for advanced practice nursing education using PRIME-NP

BackgroundClinical competency validation is essential for nurse practitioner (NP) education and public accountability. While there has been robust discussion around what constitutes clinical competency and assessment, clear and consistent definitions and measurements remain elusive. PurposeThis article describes the PRIME-NP clinical competency model that is scalable, reproducible and accurately documents NP student competency across clinical courses. MethodsTo develop the model, work in 5 discrete domains was necessary: (a) model development, (b) assessment tool to be used in Objective Structured Clinical Exams (OSCE), (c) rubrics to accompany the OSCE exam, (d) faculty education, and (e) evaluating the model use. FindingsFaculty and student outcomes reveal that the model and assessment tool acceptability and effectiveness of the model, especially for early identification for at risk students. ConclusionThe PRIME-NP offered faculty the opportunity to identify at-risk students, identify a more nuanced remediation plan, and assess student competency in simulated environments.

The Feasibility of Conducting Safe Objective Structured Clinical Exams (OSCEs) During the COVID-19 Era.

PurposeObjective structured clinical examination (OSCE) is an effective tool for learners’ assessment that require hands-on performance. During the COVID-era, many schools decided to minimize all forms of in-person communication between faculty members and students to mitigate the risk of COVID-19 transmission. We aimed to describe our experience in conducting physical OSCEs during the COVID-19 era. We also reported students’ satisfaction during this time.Materials and MethodsDescriptive cohort study by comparing the 2019–2020 cohort to the 2020–2021 cohort. Descriptive framework for the feasibility of conducting physical OSCEs in the college of pharmacy at King Saudi Bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia.ResultsThere were no reported cases of COVID-19 transmission among students and faculty members during the OSCE assessments. Overall, the 2020–2021 cohort reported increased satisfaction compared to their peers in the 2019–2020 cohort; p < 0.05. We observed an increased need for coordination to ensure students’ and staff safety while adopting machine learning applications as a public measure when possible.ConclusionOwing to the implementation of clear and strong measures, it was feasible to conduct OSCEs, and there were no reported cases of COVID-19 transmission. Other universities may adopt a similar approach so as to provide an optimal educational experience while ensuring the safety of their staff and faculty.

A telehealth-based training model for an ambulatory care pharmacy skills course

Description: Increasingly, pharmacy services are provided using telehealth-based modalities. This paper describes a pharmacy skills course that utilised telehealth principles to train students on the technical and communications skills necessary for the ambulatory care setting. Zoom breakout rooms, electronic health records, YouTube video vignettes, and teaching assistants portraying patients/physicians simulated a telehealth-based ambulatory care setting. Evaluation: Five quizzes and six written assignments were utilised to measure student’s knowledge and skills. At the end of the course, students were evaluated through a three-station objective structured clinical exam (OSCE). Students also completed a pre/post attitudes survey. Result: Overall, students performed well on various assessments including quizzes and written assignments. The majority of the students performed well on the OSCE. Significant improvement was noted on all items in the attitudes survey. Conclusion: This study suggests that a telehealth training model can be effective in teaching pharmacy students both the technical and communication skills necessary for practice in the ambulatory care setting.

Effects of rotating at a Catholic hospital on medical student contraceptive objective structured clinical exam scores

ObjectivesTo assess the impact of rotating at a Catholic vs non-religious institution for the inpatient portion of the third-year medical school obstetrics and gynecology clerkship on medical students’ contraceptive competency. Study DesignWe assigned all medical students completing an obstetrics and gynecology clerkship during the 2017–2019 academic years to a Catholic or non-religious hospital for their inpatient teaching site, where they gain much of their contraceptive counseling experience. All students attended the same didactic sessions on contraception. We compared Objective Structured Clinical Exam (OSCE) scores and clerkship grades between the two clinical sites for all medical students. We set significance at p < 0.05. ResultsOf 281 medical students, the 127 (45.2%) who had rotated at a Catholic hospital performed lower on the data-gathering component of the contraceptive OSCE compared with students at the non-religious hospitals (Catholic: 62.4 ± 16.5 vs non-religious: 70.2 ± 15.9, p < 0.01) and had lower total contraceptive OSCE scores (Catholic: 69.4 ± 9.3 vs non-religious: 72.0 ± 8.5, p < 0.01). Clinical reasoning and communication scores for the contraceptive OSCE, data-gathering and total scores for other OSCE scenarios, overall OSCE and clerkship grades were not different. ConclusionRotation at a Catholic hospital, with fewer opportunities for medical students to experience contraceptive counseling, was associated with poorer data-gathering skills for gynecologic and sexual history. While contraceptive knowledge can be imparted didactically, hands-on history-taking and counseling experiences are needed to build competency in contraceptive care. ImplicationsThere is a disparity in medical student family planning training at a Catholic hospital compared with non-religious hospitals. Contraceptive knowledge can be attained through didactic sessions, however additional hands-on practice is needed in gynecologic and sexual history taking if clinical opportunities are limited.

Hands-on training on inhaled devices to boost pharmacy students’ performance during inhaler counselling

Objective: The effective use of inhalers depends on completeness of information from healthcare providers. As pharmacists acquire foundational skills on inhalers from their undergraduate curriculum, the experience and performance of pharmacy students regarding inhaler counselling should be explored. Methods: Pharmacy students who completed their final year of study answered an online questionnaire on their experience with teaching-learning activities on inhalers. Students also underwent an objective structured clinical exam that included Turbuhaler device counselling. Results: 84 students who completed the online questionnaire strongly agreed that the curriculum increased their awareness of different types of inhalers (65.5%) and specific techniques for use (64.3%). Students reported being able to counsel on metered-dose inhaler (98.8%) and dry-powder inhaler (92.8%) techniques. Students performed well (M=9.4, SD=2.7) at Turbuhaler counselling from a full score of 14. Conclusions: The current training on inhaler devices was useful for the pharmacy students. Future training should emphasise supplementary advice on inhaler taste and gargling.

Faculty Perceptions on Objective Structured Clinical Exam in Dental Education

Structured Clinical Exam (OSCE) uses standardized content and procedures to assess students across multiple domains of learning. The study is aimed to assess knowledge, attitudes, practices and observations of dental faculty on OSCE. The survey was distributed into dental faculty members in randomly selected government and private institutions in Saudi Arabia. The questionnaire was pre-tested and consisted of 4 categories including general characteristics of respondents, knowledge on utility of OSCE in curriculum and it’s reliability, attitudes regarding OSCE on a 5 point Likert scale, practices and observations on OSCE on Multiple choice questions (both single answer and multiple answer) and responses on a 5 point Likert scale. The sample size was determined to be 93 and the survey was sent electronically to 10 institutes. 101 complete responses from 7 institutions were considered from the 122 received. Faculty participation in OSCE was high within evaluators 94% (n=94) and administrators 61% (n=61). Majority of respondents (62%) believed that OSCE is most suited for competency based education, to assess cognitive skills (73%) and diagnostic interpretation (79%). Reliability of OSCE can be increased by standardization of evaluators (77%) with highest number believing that 6-8 stations (42%) are the minimum required in an OSCE. Institution guidelines (49%) coupled with workshops (47%) was the preferred method of preparation for OSCE. Majority felt that OSCE is most suitable for high stakes exams (mean=3.37) and it is an indispensable part of dental assessment (mean=3.78). Minimum number of stations for adequate reliability was reported to be lesser that in reported literature, specially so for high stakes assessments. Logistics required for arranging an OSCE and difficulty in standardized patients, may suggest that OSCE should be used in select situations.

The critical role of direct observation in entrustment decisions.

BackgroundEntrustment decisions may be retrospective (based on past experiences with a trainee) or real-time (based on direct observation). We investigated judgments of entrustment based on assessor prior knowledge of candidates and based on systematic direct observation, conducted in an objective structured clinical exam (OSCE).Methods:Sixteen faculty examiners provided 287 retrospective and real-time entrustment ratings of 16 cardiology trainees during OSCE stations in 2019 and 2020. Reliability and validity of these ratings were assessed by comparing correlations across stations as a measure of reliability, differences across postgraduate years as an index of construct validity, correlation to standardized in-training exam (ITE) as a measure of criterion validity, and reclassification of entrustment as a measure of consequential validity.Results:Both retrospective and real-time assessments were highly reliable (all intra-class correlations >0.86). Both increased with a year of postgraduate training. Real-time entrustment ratings were significantly correlated with standardized ITE scores; retrospective ratings were not. Real-time ratings explained 37% (2019) and 46% (2020) of variance in examination scores vs. 21% (2019) and 7% (2020) for retrospective ratings. Direct observation resulted in a different level of entrustment compared with retrospective ratings in 44% of cases (p = <0.001).Conclusions:Ratings based on direct observation made unique contributions to entrustment decisions.

Adapting Medical Education Initiatives Through Team-Based e-Learning, Telemedicine Objective Structured Clinical Exams, and Student-Led Community Outreach During the COVID-19 Pandemic.

Although the COVID-19 pandemic has quickly prompted medical schools and students around the world to transition from their traditional classrooms to web-based learning, the global crisis has inspired the development of innovative e-learning solutions that use existing technology and other web-based tools to continue nurturing the education of medical students while ensuring the public health and safety of both students and faculty members alike. Through the perspective of medical students, we share how the COVID-19 pandemic has impacted and transformed small team–based learning in medical education; changed objective structured clinical exam evaluations and the practice of clinical skills through telemedicine; and nurtured nationwide, web-based, student-led initiatives for community outreach, telehealth, and medical services.

The objective structured clinical examination as an assessment strategy for clinical competence in novice nursing practitioners in Taiwan

BackgroundThe conventional written tests and professional assessment have limitation in fair judgement of clinical competence. Because the examiners may not have total objectivity and may lack standardization throughout the assessment process. We sought to design a valid method of competence assessment in medical and nursing specialties. This work was aimed to develop an Objective Structured Clinical Exam (OSCE) to evaluate novice nursing practitioners’ clinical competency, work stress, professional confidence, and career satisfaction.MethodsA Quasi-experimental study (pre-post). Fifty-five novice nursing practitioners received the OSCE three-months following their graduation, which consisted of four stations: history taking, physical examination, problem-directed management, interpersonal communication, and the required techniques of related procedures. The examiners had to complete an assessment checklist, and the participants had to complete a pre-post questionnaire (modified from a Nursing Competency Questionnaire, a Stress scale, and Satisfaction with Learning scale).ResultsAmong the novice nursing practitioners, 41 of them (74.5 %) passed the exam with a mean score of 61.38 ± 8.34. There was a significantly higher passing rate among nurses who were working in medical-surgical wards (85.7 %) and the intensive care unit-emergency department (77.8 %) compared to novice nursing practitioners working in other units. All the novice nursing practitioners at Station A had poor performance in assessing patients with a fever. OSCE performance was more associated with educational attainment and work unit, rather than the gender. Finally, the participants showed statistically significant increases in their clinical competency, confidence in their professional competence, satisfaction with the clinical practice, and decreased work stress after the OSCE.ConclusionsWe found that the OSCE process had a positive educational effect, in providing a meaningful and accurate assessment of the competence of novice nursing practitioners. An appropriate OSCE program is vital for novice nursing practitioners, educators, and administrators. The effective application of OSCEs can help novice nursing practitioners gain confidence in their clinical skills.

Using Objective Structured Clinical Exams (OSCE) to Teach Neurology Residents to Disclose Prognosis after Hypoxic Ischemic Brain Injury

BackgroundNeurologists need to be adept at disclosing prognosis and breaking bad news. Objective structured clinical examinations (OSCE) allow trainees to practice these skills. MethodsIn 2017, in conjunction with the NYU School of Medicine Simulation Center, neurology faculty designed an OSCE case in which a resident had to inform a standardized patient (SP) her father had severe global hypoxic ischemic injury. The residents were surveyed on the experience using a Likert scale from 1 (worst) to 5 (best). The SP completed a behavioral anchored checklist and marked items as “not done,” “partly done,” or “well done”. Results57 third and fourth year neurology residents completed the case from 2018 to 2020, 54 (95%) of whom completed the post-OSCE survey. Residents reported feeling moderately prepared for the simulation (mean Likert score 3.7/5), and thought their performance was average (3.4/5). Overall, they found the case to be very helpful (4.6/5). The residents performed well in the realms of maintaining professionalism (64% rated “well done”), developing a relationship (62% rated “well done”), and information gathering (61% rated “well done”). There was room for improvement in the realms of providing education and presenting the bad news (39% and 37% rated “partly/not done,” respectively). ConclusionsOSCE cases can be used to teach neurology trainees how to discuss prognosis and break bad news. Feedback about this simulation was positive, though its efficacy has yet to be evaluated and could be a future direction of study.

Does a measure of Medical Professional Identity Formation predict communication skills performance?

ObjectiveTo validate an approach to measuring professional identity formation (PIF), we explore if the Professional Identity Essay (PIE), a stage score measure of medical professional identity (PI), predicts clinical communication skills. MethodsStudents completed the PIE during medical school orientation and a 3-case Objective Structured Clinical Exam (OSCE) where standardized patients reliably assessed communication skills in 5 domains. Using mediation analyses, relationships between PIE stage scores and communication skills were explored. ResultsFor the 351 (89%) consenting students, controlling for individual characteristics, there were increases in patient counseling (6.5%, p<0.01), information gathering (4.3%, p = 0.01), organization and management (4.1%, p = 0.02), patient assessment (3.6%, p = 0.04), and relationship development (3.5%, p = 0.03) skills for every half stage increase in PIE score. The communication skills of lower socio-economic status (SES) students are indirectly impacted by their slightly higher PIE stage scores. ConclusionHigher PIE stage scores are associated with higher communication skills and lower SES. Practice implicationsPIE predicts critical clinical skills and identifies how SES and other characteristics indirectly impact future clinical performance, providing validity evidence for using PIE as a tool in longitudinal formative academic coaching, program and curriculum evaluation, and research.

A survey of teaching undergraduate neuroanatomy in the United Kingdom and Ireland

Background Medical students’ perception of neuroanatomy as a challenging topic has implications for referrals and interaction with specialists in the clinical neurosciences. Given plans to introduce a standardised Medical Licensing Assessment by 2023, it is important to understand the current framework of neuroanatomy education. This study aims to describe how neuroanatomy is taught and assessed in the UK and Ireland. Methods A structured questionnaire capturing data about the timing, methods, materials, assessment and content of the 2019/2020 neuroanatomy curriculum in the UK and Ireland medical schools. Results We received 24/34 responses. Lectures (96%) were the most widely used teaching method, followed by prosection (80%), e-learning (75%), tutorials/seminars (67%), problem-based learning (50%), case-based learning (38%), and dissection (30%). The mean amount of core neuroanatomy teaching was 29.3 hours. The most common formats of assessing neuroanatomical knowledge were multiple-choice exams, spot tests, and objective structured clinical exams. Only 37.5% schools required demonstration of core clinical competency relating to neuroanatomy. Conclusions Our survey demonstrates variability in how undergraduate neuroanatomy is taught and assessed across the UK and Ireland. There is a role for development and standardisation of national undergraduate neuroanatomy curricula in order to improve confidence and attainment.

Feedback after OSCE: A comparison of face to face versus an enhanced written feedback

BackgroundThe Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback. OSCE feedback may be in various forms (written, face to face and audio or video recordings). Studies on OSCE feedback are uncommon, especially involving Asian medical students.MethodsWe compared two methods of OSCE feedback delivered to fourth year medical students in Malaysia: (i) Face to face (FTF) immediate feedback (semester one) (ii) Individualised enhanced written (EW) feedback containing detailed scores in each domain, examiners’ free text comments and the marking rubric (semester two). Both methods were evaluated by students and staff examiners, and students’ responses were compared against their OSCE performance.ResultsOf the 116 students who sat for both formative OSCEs, 82.8% (n=96) and 86.2% (n=100) responded to the first and second survey respectively. Most students were comfortable to receive feedback (91.3% in FTF, 96% in EW) with EW feedback associated with higher comfort levels (p=0.022). Distress affected a small number with no differences between either method (13.5% in FTF, 10% in EW, p=0.316). Most students perceived both types of feedback improved their performance (89.6% in FTF, 95% in EW); this perception was significantly stronger for EW feedback (p=0.008). Students who preferred EW feedback had lower OSCE scores compared to those preferring FTF feedback (mean scores ± SD: 43.8 ± 5.3 in EW, 47.2 ± 6.5 in FTF, p=0.049). Students ranked the “marking rubric” to be the most valuable aspect of the EW feedback. Tutors felt both methods of feedback were equally beneficial. Few examiners felt they needed training (21.4% in FTF, 15% in EW) but students perceived this need for tutors’ training differently (53.1% in FTF, 46% in EW)ConclusionWhilst both methods of OSCE feedback were highly valued, students preferred to receive EW feedback and felt it was more beneficial. Learning cultures of Malaysian students may have influenced this view. Information provided in EW feedback should be tailored accordingly to provide meaningful feedback in OSCE exams.

Improving Child Neurology Residents' Communication Skills Through Objective Structured Clinical Exams.

IntroductionChild neurology has unique challenges in communication due to complex disorders with a wide array of prognoses and treatments. Effective communication is teachable through deliberate practice and coaching. Objective structured clinical exams (OSCEs) are one method of providing practice while assessing communication skills. Yet OSCEs have not been reported for child neurology residents.MethodsWe developed simulated clinical cases centering on communication skills for child neurology residents, all with challenging clinical scenarios (e.g., disclosure of a medical error, psychogenic nonepileptic events). Standardized patients (SPs) portrayed the parents of pediatric patients and, in some scenarios, an adolescent patient. We used a modified Gap-Kalamazoo Communication Skills Assessment Form to assess communication skills. The assessment was completed by faculty, SPs, and the resident, and we measured agreement among raters. Residents were surveyed afterward regarding their experience.ResultsNine cases were developed and piloted. A total of 27 unique resident-case encounters with 16 individual trainees occurred over three annual implementations. Scores on the 360-degree assessment of communication skills showed that residents overwhelmingly underassessed their skills compared to other rater groups. Among 18 responses on the post-OSCE survey, the majority (77%) found the experience useful to their education and felt that the feedback from the SPs was helpful (61%) and the case portrayals were realistic (89%).DiscussionWe implemented simulated cases for assessment and formative feedback on communication skills for child neurology residents. We provide a blueprint to develop this educational activity in other programs.

Developing Engagement Competence for Public Child Welfare: Results of an Inter-University Simulation Project

Strong clinical competence is required for the successful engagement of clients in public child welfare. Successful engagement is associated with increasing positive outcomes for families. Three universities partnered to implement a simulation based learning (SBL) project to better prepare Title IV-E students in engagement competence when working with clients in public child welfare. Over three years, 70 students participated in a two scenario Objective Structured Clinical Exam (OSCE) interviewing an adolescent and her mother regarding an allegation of abuse with post interview reflection and feedback. The project was assessed using standardized rating tools and post interview reflection responses. Students consistently performed better with the adolescent than with the mother who presented with more resistance. Performance improved when completing the OSCE twice during an academic year and when specific learning modules were added. Student management of emotional regulation, interviewing challenges, and inconsistent awareness of diversity emerged as themes from student responses. Findings suggest transfer of learning from classroom to practice situations continues to be challenging. SBL can provide an important bridge by creating practice scenarios that challenge student emotional regulation, interviewing skills, and application of culturally responsive practice in a safe and controlled environment while providing rich opportunities for student learning and development. Increased collaboration between the academy and field internship sites are needed to maximize the potential of the SBL experience.

Self-directed video versus instructor-based neonatal resuscitation training: a randomized controlled blinded non-inferiority multicenter international study.

ObjectiveTo compare the efficacy of video-assisted self-directed neonatal resuscitation skills course with video-assisted facilitator-led course.MethodsThis multicenter, randomized, blinded, non-inferiority-controlled trial compared two methods of teaching basic neonatal resuscitation skills using mask ventilation. Groups of novice providers watched an instructional video. One group received instructor facilitation (Ins-Video). The other group did not (Self-Video). An Objective Structured Clinical Exam (OSCE) measured skills performance, and a written test gauged knowledge.ResultsOne hundred and thirty-four students completed the study. Sixty-three of 68 in the Self-Video Group (92.6%) and 59 of 66 in the Ins-Video Group (89.4%) achieved post-training competency in positive pressure ventilation (primary outcome). OSCE passing rates were low in both groups. Knowledge survey scores were comparable between groups and non-inferior.ConclusionsVideo self-instruction taught novice providers positive pressure ventilation skills and theoretical knowledge, but it was insufficient for mastery of basic neonatal resuscitation in simulation environment.

Experience of implementation of objective structured clinical examination OSCE-1 Dentistry in O.O. Bogomolets National Medical University

The article is devoted to comparative analysis of the results of twoyear introduction of the Objective Structured Clinical Examination OSCE-1 for dental students of the third course at the Bogomolets National Medical University. Exam OSCE-1 consisted of 10 stations, two of which concerned general medical training of dental students, eight - special competencies in five dental disciplines. OSCE -1 in 2017/2018 189 students (78.4%) successfully passed, but 52 students (21.6%) did not. In 2018/2019 313 students of the third course of the Dental Faculty were passing to OSCE-1. It was 29.9% more than in the previous year. On the first attempt, 251 students (80.2%) passed the exam successfully, 62 students (19.8%) failed.Comparing the results of the OSCE-1 Dentistry for two years, it should be noted that students showed positive dynamics and achieved the higher level of success. In 2018/2019 with a minimum pass level of 80%, the success rate was 80.2%, and in the previous 2017/2018 year with a minimum pass level of 60% - 78.4%. Ukrainian students demonstrated a better result this year - 89.9%, which is almost 5% higher than last year. Conclusion: Objective Structured Clinical Exam (OSCI) is an effective way of assessing the practical competencies of third-year dental students.

TEACHING MUST GO ON: flexibility and advantages of peer assisted learning during the COVID-19 pandemic for undergraduate medical ultrasound education - perspective from the "sonoBYstudents" ultrasound group.

Background: Facing the global COVID-19 pandemic University teaching has been digitalized and German medical faculties took great effort to offer curricular contents online as they agreed that semesters during pandemic should not be suspended. Skill training is an essential part of medical education and cannot be fully digitalized nor should it be omitted. The pandemic demonstrates that skills like ultrasound are essential when treating critical ill patients. Medical faculties use peer assisted learning (PAL) concepts to teach skills, like ultrasound through specially trained student tutors.Aim: Here, we would like to share our experiences and elaborate how ultrasound teaching can be safely performed during the pandemic with an emphasis on adjustment of an existing PAL teaching concept.Method: At the hospital of Saarland University, we implemented a PAL teaching concept for abdominal, including emergency, ultrasound, and echocardiography, called “sonoBYstudents” to teach sonography to undergraduate medical students. Students are generally taught in small groups of 5 people in 90min sessions over a time of 8 weeks with an objective structured clinical exam (OSCE) at the end of the course program. Each semester nearly 50 students are taught in abdominal and emergency ultrasound and 30 students in echocardiography. Over five years, more than 600 students have been taught with at least 30 students being trained as student tutors. Given the pandemic, course size, course interval and total course time and total course time were adapted to the hygienic precautions. Results: 45 and 30 students were taught in abdominal ultrasound and echocardiography respectively achieving their learning goals measured via OSCE at the end of the courses. OSCE results were the same when compared to previous semesters. Conclusion: PAL as a teaching concept lives out of sustained educational strategies like practical and didactical trainings and an ongoing recruitment of new student tutors. Suspending PAL and its skill teaching would require starting from the beginning which is a time and cost consuming process. With sonoBYstudents we were able to demonstrate that an existing PAL concept can, with some effort, be adjusted to changing teaching circumstances. Apart from this ultrasound is a non-omittable part of medical skill training with easily appliable hygienic precautions during teaching sessions.

Design of a Pharmacy Curriculum on Patient Centered Communication Skills.

For delivering high quality pharmaceutical care pharmacy students need to develop the competences for patient centered communication. The aim of the article is to describe how a curriculum on patient centered communication can be designed for a pharmacy program. General educational principles for curriculum design are based on the theories of constructive alignment, self-directed learning and the self-determination theory. Other principles are paying systematic and explicit attention to skills development, learning skills in the context of the pharmacy practice and using a well-balanced system for the assessment of students’ performance. Effective educational methods for teaching communication skills are small group training sessions preferably with (simulation) patients, preceded by lectures or e-learning modules. For (formative or summative) assessment different methods can be used. The Objective Structured Clinical Exam (OSCE) is preferred for summative assessment of communication competence. The principles and educational methods are illustrated with examples from the curriculum of the master Pharmacy program of Utrecht University (The Netherlands). The topics ‘pharmaceutical consultations on prescription medicine,’ ‘pharmaceutical consultations on self-care medication’ and ‘clinical medication reviews’ are described in detail. Finally, lessons learned are shared.

The "new-normal" OSCE examination: Executing in the COVID-19 era.

In this unprecedented situation of COVID-19 era, the educational institutions have to attune not only the teaching strategies but also the assessment. Similarly, just as COVID precautions have become the “new normal” practice, hence implementation changes during face-to-face examinations may become standard practice in the Post- COVID era. The Objective structured clinical exams (OSCEs) which usually require a face-to-face assessment of skills, posed a special challenge to health professionals in COVID 19. This commentary paper is written on shared experiences of the examination cell principal resource faculty for OSCE and exam coordinators. It addresses how to plan and implement objective, valid, feasible and reliable clinical skills examinations (OSCEs) keeping in place COVID precautions to ensure the utmost wellbeing of all stakeholders involved.