Structured assessment using multiple patient scenarios by videoconference in rural settings.

Area of Science:

• Medical Education
• Rural Health
• Clinical Assessment

Background:

• Postgraduate medical curricula require robust clinical reasoning assessment.
• The Australian College of Rural and Remote Medicine identified a need for improved assessment methods.

Purpose of the Study:

• To develop, evaluate, and validate an 8-station videoconference assessment tool, StAMPS (structured assessment using multiple patient scenarios).
• To assess the reliability, feasibility, validity, and educational impact of StAMPS for rural and remote medical training.

Main Methods:

• StAMPS involved 8 stations assessing patient diagnosis and management scenarios via videoconference.
• Candidates remained at rural sites while examiners rotated at a central site.
• Reliability was assessed using generalizability theory; validity and educational impact were explored through qualitative interviews.

Main Results:

• The assessment achieved a reliability of G = 0.76 across 82 scenarios with 14 candidates.
• A moderate correlation (rho = 0.57) was found between assessment scores and candidate expertise.
• Videoconferencing was acceptable; a walking rotation system for examiners proved more reliable. Qualitative feedback confirmed relevance and acceptability.

Conclusions:

• StAMPS effectively assesses clinical reasoning, reflecting the content and remote delivery of rural practice.
• The tool evaluates resourcefulness and flexibility, with implications for distance-based medical education.
• StAMPS demonstrates reliability and feasibility, applicable in both remote and face-to-face settings.