A MedEdPublish case study of how Duke-NUS planned and conducted its final-year clinical skills exams under pandemic-era conditions showed that it was possible — even in trying and safely distanced times—for students to complete their exams and graduate as planned without compromising competency.
The authors of the case study, which included Duke-NUS educators Ms Kirsty Freeman and Professor Ian Curran, noted that there were no reports of COVID-19 infections by any person who participated in the three-day Observed Structured Clinical Examinations (OSCEs).
This was achieved by dividing the 56 students undergoing the exams into four separate cohorts with specific faculty and administrative staff assigned to each. As Freeman, Curran and the rest of their team noted that “at no time were students, staff or examiners from different circuits allowed to mix, and all were also given strict instructions about avoiding meeting and socialising” beyond their time in the School.
The educators also noted that having actual patients participating in the pandemic-era OSCEs was challenging. Patient volunteers who had healthcare contact in the fortnight previous were disallowed. Those patients allowed on-site were initially fearful of being infected with COVID-19 — conversely, the risk that these patients might end up spreading COVID-19 to the other OSCE stakeholders also had to be considered.
To mitigate and assure patients, Duke-NUS involved only patients with chronic conditions, minimising their on-site changeovers, and screening patients for travel histories as well as sick family members during the fortnight leading up to the OSCEs.
The Duke-NUS operational measures would go on to guide other medical schools in designing and implementing rigorous clinical skills examinations that, at the same time, minimised the risk to key stakeholders.
Less than two months after this, the team would once again have to re-evaluate these measures to be able to conduct the final set of exams during Singapore’s Circuit Breaker, the most restricted period in Singapore’s fight against COVID-19.