Table 2.

Coding themes for and excerpts from the tele-objective structured clinical exams.

Theme	Interview excerpt
Quality of educational experience	• ‘This was a great use of time. It didn't take much time at all, but was an excellent assessment of my knowledge and clinical judgment.’ • ‘I thought this was a really valuable experience.’ • ‘It compares to the OSCEs I've done at [the study institution] other than the fact that it was over a computer and not in person.’ • ‘I really appreciate not having to drive all the way back to [my home institution] and it worked pretty well.’ • ‘I thought it [the teleOSCE] was very effective. It is kind of a novel way of teaching. Instead of see one, do one, teach one; we just DID one!’ • ‘I think it [the feedback] was just as good as feedback I have gotten in person.’ • ‘I thought this was a good experience. I think a lot of medical students today have at least cursory experience using online video communication, such as Skype, to communicate with people. This helps integrate technology in an effective way into learning how to care for patients.’
Use of technology	• ‘It was nice that the chatroom was in a format that we were familiar with from our other sessions.’ • ‘Video quality was really clear ... it was really easy to hear and see. It was just like Skyping with someone ... pulling up pictures was doable but harder.’ • ‘I had issues. When I attempted to open both the sugar log and the photo my laptop first had to download Google Chrome (instead of Internet Explorer I was using) and then download the files. This was just too much, along with the Adobe Connect meeting room up, for my little guy [computer] to pull off all at once. It took nearly 15 minutes before I finally saw the picture. However, it was a good experience because it forced me to make a decision about patient care based solely on hx [patient history] which was good.’
Exposure to new practice models	• ‘Before, I thought that telemedicine was mainly for [my home institution] or for big city physicians to kind of consult with rural physicians, you know, like a rural physician would have a patient in their office to, like, consult with a specialist ... but then, after this experience, it kind of taught me that you can actually do visits with patients in their houses. It's never crossed my mind before that patients would have the same technology as the physician in the office so that you could do a visit with the patient in their homes by themselves, like that ... That was new for me.’ • ‘It [the teleOSCE] fits pretty well with the theme that we do have a lot of patients who have a hard time getting in to see the doctor because even though this is a rural area, they live even farther out, so I can definitely see myself doing this, you know, later on in my career when I will have to do telemedicine with patients.’ • ‘I think getting used to the idea of telemedicine ... to provide a high level of patient care to their patients is really valuable.’

OSCE, objective structured clinical exam.