Use of Computer-based Clinical Examination for Assessment of Medical Students in Surgery

Background: The Video-projected Structured Clinical Examination (ViPSCE) replaced the oral (viva) examination as a student assessment tool in clinical surgery in our department since its invention in 2001 (1, 2). It has been useful for assessing higher knowledge domain including problem-solving abilities. Objectives: To improve the viewing of the Video-projected Structured Clinical Examination (ViPSCE), we developed a computerized version, and called it 'Computerized Clinical Examination' or (CCE). This was used to assess medical students' higher knowledge and problem solving skills in surgery. We present how we did it, test scores descriptive statistics, and the students' evaluation. To our knowledge the use of computers in this way has not been reported before. Methods: A computer-based clinical examination (CCE) in surgery is administered to assess a class of 43 final year medical students at the end of their surgical clerkship. Like the ViPSCE, the exam was delivered as a slide show, using `PowerPoine computer program. However, instead of projecting it onto a screen with a video-projector, each student had his/her own computer. The CCE consisted of 20 slides containing either still photos or short video clips of clinical situations in surgery. The students answered by hand writing on the exam papers. At the end, they filled evaluation forms. The exam papers were corrected manually. The test scores descriptive statistics were calculated, and correlated with the students' scores in other exams in surgery. The evaluation forms were analyzed. Results: Administration of the CCE was straightforward. The test scores were normally distributed. They correlated significantly with the scores obtained by the students in the other exams in surgery. Students' acceptability was high. Conclusion: CCE is feasible. It inherits the validity and reliability of the ViPSCE with the added advantage of improving the viewing of the slides. It proved popular with the students.