The framework of Systematic Assessment for Resilience (SAR): development and validation.

BACKGROUND: Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice. METHODS: We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students' perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers. RESULTS: The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity. CONCLUSIONS: The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students' future use of this framework in the new normal condition (post COVID 19).

Web-based and paper-based examinations: Lessons learnt during the COVID-19 pandemic lockdown.

OBJECTIVES: This study describes the process of remote assessment in medical education during the COVID-19 lockdown and shares data-driven experiences in resolving emerging concerns. METHODS: We analysed the data of end-of-course paper-based exams (PBEs) and web-based exams (WBEs) conducted during the academic year 2019/2020. Twelve end-of-block exams were included. There were four exams each for the first-, second-, and third-year students. Eight exams were conducted as PBEs, and four were administered as WBEs. We compared the mean scores of PBEs and WBEs between exams and batches. Additionally, we compared the PBE and WBE scores obtained by 10 high-performance and 10 lowest-achieving students. RESULTS: Variations were found in the scores of students from each of the three batches in PBEs or WBEs. In a few instances, the difference was statistically significant. No specific trend or pattern was detected in the difference between the scores of PBEs and WBEs. The mean score for the WBEs was intermediate among the means of PBEs for the first- and second-year students, but lower for the third-year students. Individual students' marks in different exams consistently showed a positive correlation. The correlation was always high for PBEs (r = 0.782, 0.847). CONCLUSION: The present study showed that average and individual scores in WBEs and PBEs are comparable. Although there were some variations between the results of the two assessment modalities, no remarkable trend or pattern was observed. WBEs offer an ideal approach for formative assessment, progress testing, and the low-weight, but frequent, nature of continuous assessment.