Introduction of structured oral examination in formative assessment of pharmacology for 2nd professional MBBS students

ABSTRACT

Background: Conventional Oral Examination (COE) is criticized for being too subjective and being influenced by academic and non-academic factors. Another pitfall of COE is unequal distribution of time. Different examiners use a different set of questions with varying difficulty levels. Student related factors include gender, accent, vocabulary used and ability to pick nonverbal cues. These factors make COE less reliable and valid assessment tool. To overcome the limitations of this useful tool, SOE can be implement instead of COE.Methods: It is a prospective and non-randomized study comprising 79 students of pharmacology appeared for two forms of viva i.e. COE and SOE. Three sets of questionnaires - Must know, should know and nice to know were prepared, each having 15 items with increasing difficulty levels and were validated by subject experts and pretested. Ten minutes were allotted for each student for each form of viva. Feedback of students about the novel method was obtained by using semi-structured questionnaire comprising of 19 closed ended questions and one open-ended question.Results: Structured oral examination (SOE) yielded significantly higher marks as compared to COE. There were significant inter-examiner variations in marks awarded in SOE and COE. Other factors influencing implementation were difficulty in structuring viva, rigid time limits, lack of flexibility in knowledge content, monotony and fatigue. The students perceived this format not different from COE but felt that it required in depth preparation of topic.Conclusions: Conducting SOE is a resource-intensive exercise. Despite structuring, inter-examiner variability was not completely eliminated. The student’s performance was depended on factors related to examiners such as teaching experience, vernacular language used, and lack of training. Orientation and training of examiners in assessment strategies is necessary. Standardization of questionnaire is necessary before the implementation of SOE for summative assessment.