Exploring the Feasibility of an Examiner-Worn Neck-Mounted Camera for Objective Structured Clinical Examination Assessment: Pilot Feasibility Study

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Cohen κ agreement between live and video assessment: mean 0.67 (SD 0.20)

• Primary Outcome: Feasibility of neck-mounted camera for OSCE assessment

• Nnt Or Sensitivity: 89% completion rate for video-based reassessment; neck-mounted camera showed superior evaluability for fine motor skills compared to fixed camera

• Confidence Interval: Not reported

Clinical Application

Promising but requires further development to address audio quality, comfort, and viewing angle limitations Relevant to Australian medical schools facing examiner shortages; could support RACGP clinical skills assessment and university OSCE programs, though cost-effectiveness analysis needed for widespread implementation Medical education institutions conducting OSCEs, particularly for skills requiring detailed observation of fine motor tasks

Abstract

BACKGROUND: The Objective Structured Clinical Examination (OSCE) is a prevalent method for evaluating clinical competence in medical education. As OSCEs become increasingly standardized and resource intensive, alternative evaluation methods are being explored, particularly because of the limited availability of certified examiners. However, few studies have investigated whether wearable technologies can support OSCE assessment. Wearable devices may provide a means of recording clinical skills from the examiner's perspective. OBJECTIVE: This pilot study, conducted in 2024, aimed to investigate the feasibility of using an examiner-worn neck-mounted camera for recording OSCE scenarios and to evaluate the evaluability of clinical performance from the recorded footage. METHODS: In total, 9 experienced medical educators participated in a simulated OSCE scenario involving electrocardiogram lead placement. All participants completed the initial live assessment and the postuse questionnaire, while 8 of 9 (89%) participants completed the subsequent video-based reassessment. Video recordings from both a fixed camera and a neck-mounted camera (THINKLET) were used to assess the evaluability of each OSCE item. Following a washout period, evaluators reassessed the neck-mounted camera recordings by using the original checklist, while fixed-camera recordings were used to judge the evaluability of each item. Agreement between live and video-based scoring was analyzed using percent agreement and the Cohen κ coefficient. A postevaluation questionnaire captured evaluators' experiences with the wearable device. RESULTS: Cohen κ ranged from 0.258 to 0.913 (mean 0.67, SD 0.20). Across checklist observations, more items were judged to be evaluable in the neck-mounted camera recordings than in the fixed-camera recordings, particularly for tasks requiring observation of fine motor skills. Evaluators reported generally positive experiences with the device, although some noted issues related to audio quality, comfort, posture restriction, and limited visibility at low angles. CONCLUSIONS: Although further investigation is needed, this pilot study suggests that an examiner-worn neck-mounted camera may be a valuable supplementary assessment tool for selected OSCE tasks. Further work is needed to refine the device, standardize recording protocols, and clarify how it can best support review and verification alongside live evaluation.

References

1. 1.Sekine, M., Nishizaki, Y., Endo, A., Ogawa, T., Takeshita, Y., Nasu, M., Wada, H., Miyamoto, C., Oguro, M., Otake, C., Konishi, Y., & Tomiki, Y. (2026). Exploring the feasibility of an examiner-worn neck-mounted camera for objective structured clinical examination assessment: Pilot feasibility study. JMIR Medical Education. https://doi.org/10.2196/87483