Remote OSCE: Simulated Patient Training

Hi I’m Trish from Speedwell.

In this clip we see how a simulated patient enters a remote osce exam with a candidate and one examiner present.   There will be instructions (including an image) for the simulated patient to read.

The patient enters the exam early and reads their instructions. When the examiner joins they can see and talk to each other with their webcams and mics.  Once the candidate joins, the exam starts the patient and candidate use the interactive image to explore the pain issues. . They both mark the image and see the updated image at the same time. The examiner watches the interaction and marks the candidate.

At the end of the station, the simulated patient remains with the examiner, whilst the candidate moves on to the next station. The patient and examiner wait for the next candidate to join.

The simulated patient will need the URL details to browse to the eSystem sign in screen, and their unique username and password details.

They will browse to speedwell esystem delivery and sign in screen. They will also need their username and password which they enter here to sign in.

The exams delivery screen loads when they sign in, and their user details and sign out options are showing in the top right over here.

This exams screen shows that there is one exam ready to enter. The simulated patient should have already run the remote osce computer check (There is a separate clip for that).

Each exam is dated and timed and the simulated patient can check the details here. And go back to their exams.

The simulated patient enters the exam using this button. At the top left the patient can change the screen options, here.

As the patient has entered the exam early they will need to wait for the exam to start. here at the top left we can see the exam timer.

This will count down to the start of the exam, then count down through any allocated candidate reading time, then, count down through the remaining station time. For the next station it will count down through any station waiting time, any reading time, the remaining station time and so on until the exam has finished.

On the right we have exam and station details on the top right. And the webcam panels, with the patient webcam showing at the bottom.

The simulated patient webcam loads on the right, below the examiner webcam space. The simulated patient reads their customised instructions whilst they are waiting for the exam to start. They have also been shown the image which they can take zoom in on. like this, for a closer look.

Once the simulated patient has finished the whole exam, they will leave the event using this button.

On the right the simulated patient can click the help button to load and use an onscreen chat facility.  They can type messages to the administrator in here and answer messages will also show in here.

Simulated patients can mute their mics like this, turn off their webcams like this and use alternative mic or cam, if they have any available, using this settings button.

The examiner joins (their webcam is at the top) and this patient and examiner can now see and talk to each other.

When it is time for the exam to start, the first station reading time begins, as we can see in the timer here. When reading time is over, the station starts, the candidate joins automatically and their webcam repositions at the top, with the simulated patient now showing the bottom next to the examiner webcam.

The station has begun, and after this examiner introduces the station, the simulated patient and candidate can start their conversation, whilst the examiner marks.

If a floating examiner is observing, this icon shows at the bottom. The observer can’t be seen or heard but can see and hear everyone else. The icon disappears once the observer has moved out of the station.

During this station, the candidate would like to share the image with the SP, and wants the SP to use the image to clarify symptoms. They share it by clicking to place their marker on the image.

Here is an example of what the candidate and patient see on their respective screens.  The candidate screen shows on the left they begin by placing their c marker to share the image. The simulated patient screen here on the right shows the patient placing their own simulated patient markers.  Both candidate and simulated patient can see and interact with exactly the same screen at the same time placing their own markers (C for candidate, SP for simulated patient). They can both see all markers.

Back to our exam and this candidate has clicked on the image (we can see their C marker). The simulated patient adjusts the image to their preference and can then place their SP markers when asked to clarify the details and the both the candidate and simulated patient see and use the same image which is simultaneously updated.

This simultaneous screen-sharing and interaction is very useful for detailing and clarifying discussion points. OSCE stations can contain multiple shared images, which can used by Candidates, Simulated patients and examiners too.

When the simulated patient and candidate have finished this discussion, the image can be closed by the simulated patient and the patient and candidate continue with the rest of the station.

This station is nearly finished. As the timer counts down the candidate ends the discussion with the Simulated Patient.   The candidate is moved automatically to the next station. The Simulated Patient webcam is now showing at the bottom, with the examiner webcam at the top.  Before the next station there is waiting time, and then some reading time.  When any allocated waiting and reading times are finished the next candidate will join, the webcams will reposition, and the station will begin again.

Once the last candidate has finished at the station, the timer will show an exam finished notification and the Simulated Patient can leave using the LEAVE button here at the bottom.

This will take them back to the exam screen.