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Clinical Practice

Clinical and professional practice form a key component of health science degrees such as nursing, medicine, pharmacy and dentistry. Clinical skills include, history taking & case presentation, basic life support, and routine examinations and tests. The assessment of clinical practice skills generally requires students to perform or demonstrate the skill using the instruments correctly where required. In medicine these skills have been traditionally examined using Objective Structured Clinical Examinations (OSCE’s), whereby students are given the opportunity to demonstrate either a practical or theoretical skill at a station.  

Typically used to…. 

  • assess students’ ability to perform the routine clinical skills required to assess, diagnose and treat a patient  
  • evaluate students’ mastery of utilising the instruments required to assess patients  
  • assess students’ capacity to work independently and professionally within the field  


Consider the assessment in the context of the module or programme.   

Clinical practice may be an entire module, such as a fundamental course in clinical and professional practice, and therefore be used to assess the complete set of learning outcomes for the module.  

Clinical practice may also be an integral part of a module and the assessment may be used to:  

    • provide feedback to students on their ability to connect theoretical understanding to practice  
    • assess skills associated with the diagnosis and treatment of patients  

Ask the question as to how assessment can be used to demonstrate that the student has achieved the relevant learning outcome.  


OSCE’s allow candidates to be thoroughly tested in a timely manner whilst preserving patient (and candidate) safety. 

When used in a digital format the following advantages accrue: 

  • Prepares students for telehealth and is suitable for assessment of many clinical competencies 
  • Low-cost and easily accessible equipment (skype/zoom/MS Teams) needed and is convenient in terms of reduced travel needed for students and examiners 
  • Enables adherence to social distancing guidelines and enhances safety and candidate safety 

Examiner ratings are reasonably comparable when OSCEs are assessed online vs face-to-face. Favourable feedback is reported by examiners and students. 

Formative or Summative

Are you intending to use the clinical practice assessment for formative or summative assessment purposes, or both?  

  • Consider at what stage(s) formative assessment will be most valuable to the students and how students should be able to act on the feedback prior to final assessment  
    • One useful technique is to ask students to video themselves completing one of the skills and submit it in advance of the summative assessment for feedback 
  • Formative assessment can also help students identify strengths and areas to develop in advance of clinical placement and entering the profession. 
  • If summative only, consider how your students will obtain the skill to complete the assessment successfully.  


Carefully consider how you will grade the skill competency

  • What criteria will you use to assess students’ engagement?  
  • Have you provided students with a rubric?  
  • Does the rubric align with the relevant learning outcomes?  
  • Do your teaching strategies align with this assessment?  

Going Digital

It can be difficult to replicate OSCE’s online. It may not be possible to assess the full range of skills required of the student. Select those skills that you think are best situated to the digital format.  

Consider whether the assessments needs to be in real time, using Blackboard Collaborate for example, or whether students should upload a recording. If online, virtual stations should be set up in advance with examiners in the room or ‘station’ prior to student entry. If recorded ask students to record themselves while completing one of the skills and to review the video before they upload it, to ensure that they have clearly captured the skill demonstration. 

Student Support

Students need a clear picture of what is required of them before they can complete the essay successfully.  

  • Have you provided students with clear guidelines on the format and requirements of the assessment of the clinical skill? 
    • For example, do they have a clear understanding of the skills being assessed and the competence required?  
  • How can you use your teaching strategies to support students understanding of what constitutes demonstrating competency in a clinical skill? 
    • For example, do you have video or simulation demonstrations of the skills? 

Organise a dummy run through of the process with the students and examiners in advance to iron out any potential difficulties. 


Make sure your students are aware of the submission procedure and any deadlines when uploading video recordings 

  • How and when will students submit the videos?  
    • For example, will you require students to submit through the VLE Assignments tool or via email? (See suggestions for relevant tools and technologies below.)  
    • Will you allow multiple submission attempts or one attempt only?  


Before you embark on the assessment consider what challenges you may have in relation to using digital in OSCE’s.  

  • Will it be possible for the student to adequately demonstrate their competence of the set of skills that you have chosen to assess digitally? 
  • Consider giving students the option of having the skills assessed in a clinic or remotely? 
    • Some students may be more comfortable having an in-person assessment 

For video demonstration uploads consider: 

  • Whether the students have sufficient equipment available to adequately record themselves demonstrating the skill, ie. a mobile phone with a camera and a stand, the correct medical equipment 

For online live demonstration of skills consider: 

  • The technical requirements such as wifi, laptops and audio quality required 
  • Make provision, and inform students in advance, for call drop out and any contingencies required 

Case studies - Using digital Technologies to enhance assessment of clinical practice skills

Using digital Technologies to enhance assessment of clinical practice skills

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