Can a Neck-Worn Wearable Camera Support OSCE Evaluation?

A research group led by Assistant Professor Miwa Sekine, Professor Yuji Nishizaki, and Professor Yuichi Tomiki from the Department of Medical Education at Juntendo University School of Medicine investigated whether video from a neck-worn wearable camera worn by evaluators could be used for evaluation in the Objective Structured Clinical Examination (OSCE)*¹, a practical exam that medical students must pass to advance to clinical clerkships. The OSCE is a crucial practical exam to confirm that medical students can perform examinations and basic procedures safely and appropriately. Maintaining evaluation quality requires video recordings that allow later review of the exam. However, conventional fixed-camera footage can have its view obstructed by the positions of evaluators, examinees, and simulated patients, making it difficult to fully observe fine manual operations. In this study, a mock OSCE involving the placement of 12-lead electrocardiogram (ECG) electrodes was conducted. The number of assessable items from video captured by a neck-worn wearable camera worn by the evaluator was compared with that from fixed cameras placed at the head and foot of the examination bed. The results showed that the neck-worn wearable camera footage allowed more evaluation items to be judged as 'assessable' compared to fixed cameras, suggesting its potential usefulness, particularly for verifying fine procedural details. However, the degree of agreement between the on-site evaluation during the exam and the re-evaluation conducted later using the recorded video varied among evaluators, indicating the importance of standardizing wearing methods and recording conditions for practical application. This finding suggests that neck-worn wearable cameras could serve as a supplementary tool to support OSCE evaluation. The paper was published online in the international medical education journal JMIR Medical Education on May 27, 2026.

Key Research Findings - In a mock OSCE, the degree of agreement between 'on-site evaluation during the exam' and 're-evaluation using video recorded by a neck-worn wearable camera' was compared. - The degree of agreement between 'on-site evaluation during the exam' and 're-evaluation using recorded video' varied among evaluators, indicating that standardizing wearing methods and recording conditions is important for stable use. - The 'neck-worn wearable camera' footage was judged to have more 'assessable' evaluation items than the 'fixed camera' footage, suggesting its usefulness for verifying fine procedural details.

Background The OSCE is a crucial practical exam to confirm that medical students can perform examinations and basic procedures safely and appropriately before advancing to clinical clerkships. Students cannot proceed to clinical training without passing the OSCE. However, conducting OSCEs requires many evaluators and administrative staff, and establishing a system to maintain evaluation quality while ensuring stable implementation is a challenge. In recent years, the importance of recording exam scenarios as video for later review of evaluations has increased. However, conventional fixed-camera footage can have its view obstructed by the positions of evaluators, examinees, and simulated patients, making it difficult to fully observe fine manual operations or electrode placement positions. Particularly for tasks requiring verification of fine techniques and positions, such as 12-lead ECG electrode placement, fixed-camera footage alone may not adequately record the information needed for evaluation. Therefore, this research group focused on a 'neck-worn wearable camera' that evaluators wear around their neck to record footage close to the evaluator's viewpoint, and verified whether video from this camera could be used for OSCE evaluation.

Content In this study, a mock OSCE involving the placement of 12-lead ECG electrodes was conducted. Nine physicians with clinical education experience participated as evaluators and performed on-site evaluations during the exam. The exam was recorded using a neck-worn wearable camera worn by the evaluator and fixed cameras placed at the head and foot of the bed. To minimize the influence of memory from the day, evaluators reviewed the video of the same mock OSCE recorded by the neck-worn camera after an interval of approximately one month. One month later, they re-evaluated the examinee's procedures using the same evaluation form used on the day. Analysis of the agreement between the 'on-site evaluation during the exam' and the 're-evaluation using recorded video' showed variability among evaluators. However, comparing the fixed camera footage with the neck-worn wearable camera footage showed that the neck-worn wearable camera footage was judged to allow confirmation of more evaluation items than the fixed camera. Its potential usefulness was particularly suggested for verifying fine manual operations, such as ECG electrode placement positions. These results suggest that the neck-worn wearable camera can complement fine manual operations that are difficult to verify with fixed cameras, and when used in conjunction with fixed cameras, can enhance video recording and post-exam review in OSCEs. However, it was also clarified that standardizing the wearing method and recording conditions of the neck-worn wearable camera is important for stable use.

Future Developments Although this study was a pilot study conducted with a single task and a small number of participants, it suggested that utilizing neck-worn wearable cameras could lead to improved quality of evaluation records in OSCEs and support evaluation within limited human resources. Future plans include conducting verification with an increased number of subjects, multi-institutional evaluations, application to different OSCE tasks, and standardizing wearing methods and recording conditions to build a system that can be used more practically in educational settings.