Effectiveness of remote practical boards and telesimulation for the evaluation of emergency medicine trainees in India

Purpose: Travel restrictions during the pandemic created a barrier to the traditional in-person, observed assessment final examination of our emergency medicine (EM) training programs in India. We conducted remote practical boards and telesimulation bringing examiners and learners from different geographical locations together using an online video conferencing platform. The goal of this paper is to describe the process of implementing a large-scale, international remote practical boards and telesimulation event. We aim to describe the evaluations of the feasibility and effectiveness of remote practical boards and telesimulation in an examination scenario and the feedback regarding the perception of fairness and attitudes from both examiners and examinees. Methods: A total of 104 residents from 14 separate hospitals in eight cities across India were evaluated individually for practical board cases and in pairs for telesimulation. For practical boards, each examinee was evaluated twice, by two independent examiners. For telesimulation, each pair was evaluated by a local facilitator and a remote examiner via an online platform. There were 27 practical examiners and 14 local facilitators and 10 remote examiners for telesimulation. We obtained feedback in the form of a survey from local and remote examiners and examinees. Results: We implemented a large-scale, international remote practical boards and telesimulation event, connecting examinees and local examiners in eight cities in India with examiners in the United States and United Kingdom. Feedback was obtained from 24 examiners and 103 examinees. A total of 96.7% examiners and 96.9% of examinees felt that this examination was fair. All respondents agreed that this format saved time and costs. Conclusion: This remote practical boards and telesimulation experience was a feasible and effective way to evaluate EM examinees medical knowledge, communication, and procedural skills. Technology issues was a limitation of our telesimulation experience. Future studies on telesimulation use in global EM training would be useful.