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COVID-19 Effect on Clinical Examination Scores: Has Virtual Learning Affected Medical Student Obstetrics & Gynecology (OBGYN) Objective Structure Clinical Examination (OSCE) Scores?

Resident: Victoria Biach, MD

Faculty Advisor: Alexandra Regens, MD

Background

On March 13, 2020, the AAMC made the unprecedented decision to recommend the removal of medical students from clinical clerkships. At the time it was recommended for a minimum of 6-8 weeks. Students at University of Oklahoma Health Sciences Center (OUHSC) were removed from clinical rotations for six weeks. Per a cross sectional study with 741 medical student, 74.7% respondents overall agreed their medical education had been significantly disrupted by COVID-19 and 61.4% felt their interruption from clinical rotations interfered with their ability to develop skills needed to prepare for residency. This raises the question of how the virtual nature of clinical rotations affected the performance of students at OUHSC on the OBGYN OSCE examination. The hypothesis is students prior to virtual clinicals will have higher OSCE scores than students with clinical rotations affected by the pandemic.

Methods

This is a retrospective review of all students at the University of Oklahoma Health Sciences Center (OUHSC) who completed the OBGYN OSCE examination during the years of 2018-2022. Two cases were analyzed that represented inpatient postop and outpatient gynecology clinical scenarios. Four cohorts were analyzed: in-person, virtual, pre-COVID, and post-COVID students. Data was analyzed by calculating chi-square or Fisher Exact tests as appropriate for each comparison in order to report the percentage with the p-value for the difference in proportions.

Results

Seventy-two percent of the questions analyzed were not statistically significant. When looking at the trends in the statistically significant questions, pre-COVID students performed better in the respiratory and lower extremity physical exam when compared to the post-COVID students. Post-COVID students, however, performed better obtaining a gynecologic history and educating about the incentive spirometer than pre-COVID. In addition, the post-COVID and virtual students counseled on the plan for further evaluation more frequently than in-person and pre-COVID students.

Conclusions

While hopefully the world never experiences an event such as the COVID-19 pandemic again, this study demonstrates the success of virtual learning with students after COVID and virtually performing comparable to pre-COVID students on the majority of questions. This study is limited by the retrospective nature and inability to stratify this data with information about what student’s clinical experiences looked like as this was constantly evolving throughout the pandemic.








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