Neck-mounted cameras improve medical student clinical skill assessments

Assessing the clinical skills of medical students before they enter real-world patient care is a critical component of medical education. While medical training provides students with essential knowledge, it is equally important to ensure they can apply that knowledge safely and effectively in clinical settings. To evaluate this readiness, medical schools widely use the Objective Structured Clinical Examination (OSCE), a competency-based assessment that measures practical skills, communication, professionalism, and clinical decision-making through standardized clinical scenarios.

Despite its value, the OSCE is resource intensive, requiring trained evaluators, support staff, and substantial logistical coordination to maintain assessment quality. Video recording is often used to support documentation and post-examination review, but conventional fixed cameras can struggle to capture fine procedural details because of limited viewing angles, distance from the examinee, and visual obstructions. To address these challenges, researchers in Japan investigated whether an examiner-worn, neck-mounted camera (THINKLET) could supplement the observation and review of clinical skills during OSCE assessments. Assistant Professor Miwa Sekine explains, "We investigated whether this camera could help evaluators confirm fine procedural skills in OSCE assessments and facilitate post-examination review." The study was published in JMIR Medical Education on May 27, 2026.

The researchers evaluated the technology in a simulated OSCE focused on 12-lead electrocardiogram (ECG) electrode placement, a procedure that requires accurate identification of anatomical landmarks and precise hand movements. A fifth-year medical student served as the examinee, while nine experienced medical educators acted as evaluators. During the live assessment, evaluators scored performance using a 26-item checklist while both a neck-mounted camera and fixed cameras recorded the examination. After a one-month washout period, the evaluators reassessed performance using the wearable-camera footage. The researchers then compared live and video-based scores, examined how many checklist items could be reliably evaluated from each camera type, and gathered feedback on the device's usability.

The results showed moderate to strong agreement between live and video-based assessments, with Cohen's kappa values ranging from 0.258 to 0.913 (mean 0.67), indicating varying but generally favorable agreement between live and video-based assessments. Most checklist items achieved agreement rates of 75%–100%. Notably, the neck-mounted camera enabled more observations to be evaluated than the fixed camera, producing 206 evaluable observations compared with 185. This advantage was most apparent for tasks requiring close visualization of hand movements and ECG electrode placement. Evaluators also expressed overall support for incorporating video-based assessments into future OSCE practice. However, they identified several practical challenges, including audio limitations, occasional obstruction of the field of view, device slippage, heat generation, and difficulties handling evaluation forms while wearing the camera.

Overall, the findings suggest that examiner-worn, neck-mounted cameras could serve as a valuable complement to conventional recording methods in the OSCE. Dr. Sekine noted, "Combining a neck-mounted wearable camera with a fixed camera may help supplement the observation of detailed procedural steps, supporting the documentation of OSCE assessments and post-examination review." She adds, "Such an approach could provide an additional option for supporting documentation and review of OSCE assessments, particularly in settings where evaluator resources are limited."

Although larger studies involving multiple institutions and a broader range of clinical scenarios are needed, this pilot study highlights the potential of wearable recording technology to enhance the evaluation of procedural skills. As medical education continues to emphasize competency-based assessment, examiner-worn cameras may offer a promising approach for supporting OSCE review and improving documentation of procedural skills, although further validation is needed.