Adaptation to Open-Book Online Examination During the COVID-19 Pandemic

INTRODUCTION: COVID-19 altered medical education systems worldwide as many medical schools quickly changed to online assessment systems. However, the feasibility of online assessment and how it compares to traditional examinations is unclear. METHODS: We compared 4th year medical students' online surgery clerkship assessment scores to the traditional written examinations. The percent of correct scores using online open-book examination was compared to the results of the traditional closed-book examination in the previous three rotations. Additional correlation between grade point average(GPA) and examination performance were reviewed. RESULTS: Compared with the traditional groups, medical students who took the online, open-book examination had a significantly higher mean score in both MCQ (85.21 vs. 77.36, 72.43, 83.00, p<0.001) and essay examinations (187.36 vs. 158.77, 152.17, 152.29, p<0.001), but a significantly lower mean score in short answer examination (60.09 vs. 66.79, 67.73, 64.82, p<0.001). The online open-book examination group had a significantly lower correlation between the essay score and their GPA than the previous traditional groups (z=2.81 p=0.005, z=2.23 p=0.026, z=2.19 p=0.029). CONCLUSION: Although an online, open-book examination was feasible during the COVID-19 pandemic, this study indicates that mean scores are significantly different which has important implications regarding grading and standard setting. More research is required to assess other effects of this new assessment on long-term knowledge retention and application. ((C) 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Automated summary

This study compared the performance of online open-book examinations with traditional closed-book examinations, finding that the online group had significantly higher scores in multiple choice and essay examinations, but significantly lower scores in short answer examinations. The correlation between essay scores and GPA was also significantly lower in the online group compared to the traditional groups.