Effective doctor–patient communication is a core competency for healthcare professionals. With the pivot to online clinical education and assessment due to the COVID-19 pandemic, there was a need to explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examinations.

The study was designed as descriptive qualitative research. All candidates and examiners of the September and November 2020 sitting of online Basic Specialist Training exam (a clinical Objective Structured Clinical Examination exam completed in the first 4 years of psychiatry training) were invited to participate. The respondents were interviewed by Zoom which was transcribed verbatim. Data were analyzed by NVivo20 pro and various themes and subthemes were drawn using Braun and Clarke thematic analysis.

A total of seven candidates and seven examiners were interviewed with an average duration of 30 minutes and 25 minutes, respectively. Four main themes emerged: Communication, Screen optimization, Continuation postpandemic and Overall experience. All candidates preferred to continue an online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups.

The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking up nonverbal cues. Overall minimal technical issues were reported. These findings may be helpful to modify current psychiatry membership examinations or similar assessments in other countries and specialties.

Covid-19 pandemic caused a pivot to online clinical education and assessment across the globe.

To explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examination.

This study was designed as interpretive descriptive qualitative research. All candidates and examiners of the online Irish Basic Specialist Training exam in September and November 2020 were included. The respondents were interviewed by Zoom which were transcribed verbatim. Data was coded using NVivo20 pro and Braun and Clarke thematic analysis was used to draw various themes and subthemes.

A total of seven candidates and seven examiners from different training deaneries and specialties were interviewed with average duration of 29m 45s and 24m 20s respectively. The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking nonverbal cues. The candidates were very conscious of eye contact while examiners placed more emphasis on overall professional behavior and patient engagement. All candidates preferred to continue online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination due to some limitations in assessing physical and cognitive examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups.

The results of the study have shown different insights of two important stakeholders in a professional postgraduate psychiatry examination which can be useful to improve same exam and design similar assessments in other settings.

No significant relationships.

Paramedicine is experiencing significant growth in scope of practice, autonomy, and role in the health care system. Despite clinical governance models, the degree to which paramedicine ultimately can be safe and effective will be dependent on the individuals the profession deems suited to practice. This creates an imperative for those responsible for these decisions to ensure that assessments of paramedic competence are indeed accurate, trustworthy, and defensible.

The purpose of this study was to explore and synthesize relevant theoretical foundations and literature informing best practices in performance-based assessment (PBA) of competence, as it might be applied to paramedicine, for design or evaluation of assessment programs.

A narrative review methodology was applied to focus intentionally, but broadly, on purpose relevant, theoretically derived research that could inform assessment protocols in paramedicine. Primary and secondary studies from a number of health professions that contributed to and informed best practices related to the assessment of paramedic clinical competence were included and synthesized.

Multiple conceptual frameworks, psychometric requirements, and emerging lines of research are forwarded. Seventeen practice implications are derived to promote understanding as well as best practices and evaluation criteria for educators, employers, and/or licensing/certifying bodies when considering the assessment of paramedic competence.

The assessment of paramedic competence is a complex process requiring an understanding, appreciation for, and integration of conceptual and psychometric principles. The field of PBA is advancing rapidly with numerous opportunities for research.

TavaresW , BoetS . On the Assessment of Paramedic Competence: A Narrative Review with Practice Implications. Prehosp Disaster Med. 2016;31(1):64–73.