Conducting assessment in any form to evaluate the student's knowledge and practical skills is an essential component to certify if they have attained the required competency prescribed by the training program. The COVID-19 pandemic has propelled all most all educational institutions to use the online platform including medical institutions (11, 12). Several innovative and novel methods have been employed by Higher Educational Institutions to deliver education to their students ensuring their safety. Various online platforms such as Zoom are being used extensively to create engagement with medical students (13). This approach has proved beneficial to those students who had returned to their native place during the COVID-19 pandemic. They could access the lectures and study material from the comfort of their homes ensuring that they stay updated with the curriculum. This mode of learning was well received by the medical students who could discuss clinical conditions, interesting case studies, and exam-related questions allowing them to stay connected throughout these unprecedented times.
This transition of medical education to online mode has seen significant changes in the assessment methods. Imperial College London was the first to conduct an online examination for their medical undergraduates (8). This approach was followed by several medical schools in the interest of their student's future, with various universities opting for open-book examinations. Written assessments can be comfortably carried out on the online platform, however, the challenge still occurs in the conduct of the online practical assessment. Here, we have tried to create an online practical assessment model for Biochemistry considering all the domains and levels of Bloom’s taxonomy. We have also analyzed the feedback of the students and the faculty towards the design and conduct of the online assessment. The conduct of the online practical assessment was well received by both students and faculty. We employed the face-to-face interactive approach using the breakout room option of Zoom for the conduct of the assessment. Each student was individually interviewed by the faculty in charge over 15 to 20 minutes assessing mainly the cognitive and affective domain as well as the various levels like “knowledge”, “understanding”, “apply”, “analyze” and “evaluate”. The highest level “create” and the psychomotor domain could not be assessed.
Among 200 students, 63.7% of the students had good computer skills, 88.7% of the students did not have difficulty following the instructions provided before the assessment and 93.1% of the students were comfortable with the Zoom platform chosen for the assessment as the same platform was used for the online classes. About 89.2% of the students agreed that the online assessment helped them to understand their preparedness in Biochemistry, however, only 43.6% of the students felt good about their performance and an equal percentage of them (43.1%) were neutral about it, and 72% of them felt that it was a good indicator of how well the students understood the topics. Nearly 95.1% of the students opined that the assessment was conducted in a fair manner, 88.7% of them agreed that the time allotted for them during the assessment was sufficient and 95.1% of them felt that the faculty were competent to conduct the online practical assessment. About 79.5% of the students opined that they did not use unfair means, and 48.1% of them were less anxious during the assessment, 86.3% agreed that the assessment was consistent with the topics taught in the regular classes. The majority of them (40.7%) were neutral about their preference for online or offline assessment, while 34.8% preferred online and 24.5% preferred off-line assessments suggesting a mixed opinion. However, 77.9% of them opined that online assessment was a good alternative to offline assessments during the pandemic as they have a positive effect on the student’s learning process. Overall, 94.1% of the students rated the conduct of the online practical assessment as very good and excellent.
A prospective cohort study carried out on undergraduate students in pharmacology showed a good correlation between online assessment parameters and summative examination performance. This indicated that the regular online assessments may help identify students who would benefit from remedial measures (14). A similar aspect was observed in our study as the faculty had one-to-one interaction with the student in the virtual model, students were at ease and opened up easily as they were in the comforts of their home. This enabled the faculty to provide critical feedback to the students on the areas they could improve. We report a significant difference in the opinion of the students with and without previous experience in online assessment, however, this can be addressed by providing them with few training sessions so that they can perform better and be at par with their peers. An exploratory case study was carried out on third-year medical students in Saudi Arabia has reported that the formative online assessment on Blackboard improved the student's performance in the final exam and the blended learning method was liked by a majority of the students (15). A study was done to understand the perception of the first-year undergraduate medical students on the reliability, usefulness, and practical challenges in the conduct of the online tests reported that online formative assessments were helpful for the students despite practical challenges like network connectivity issues. The most reliable assessment method was viva-voce by video conferencing and the most practically feasible method was the multiple-choice-question-based assessment (16). The network connectivity issue was one of the challenges mentioned by the students in the descriptive section of the questionnaire. Also, a few of them faced difficulty writing the exam with the screen in from of them. However, the face-to-face viva-voce was appreciated by the students as it can curb malpractice. Most of the students liked the comfort of being at home and writing the exam, felt less anxious as it was a stress-free environment, liked the face-to-face interaction, could manage their time better, using earphones helped them to concentrate better, felt that the assessment was systematic and organized, helped them to focus on their exam and were not distracted by their peers. On the whole, the students and the faculty had a new and good experience.
Several advantages for the conduct of online examinations have been listed: they are environment friendly minimizing the wastage of paper; economical considering the reduced human, logistic and administrative costs; and easy to use both by the examiner and the examinee; assessment may be taken from the comfort of the students home; allows the faculty to monitor the students throughout the course in real-time; unique alternatives to the traditional assessment patterns may be discovered and applied to create interests in the minds of the students and motivate them. Several disadvantages have also been listed for this mode of assessment: challenges in adopting new technology may create minor disruption but can be overcome by a brief period of familiarization by the user; infrastructural barriers where access to electricity and stable internet connectivity may be difficult to achieve; long-type subjective answers and practical skills are difficult to assess and may require upgrading of the technology; susceptible to practice unfair means as students may restore to impersonation or use of external help during the assessment which may require artificial intelligence-based proctoring features or transitioning to open-book exams as it may be difficult to avoid students from using external help during the online assessment (9, 10). Educational institutions may opt for adapting the online teaching-learning & assessment strategies in their regular academic program, which will help them to take benefit of the advantages listed above and also familiarise the students & faculty with these tools to be better prepared for any such situations in future.
The limitation of the study is that we could not correlate the marks of the students with and without previous experience in online assessment as the feedback was collected anonymously. This study was carried out in a single Private Medical School and may be a basis for multicentric studies on a larger cohort for confirmation. Also, further studies may be carried out to investigate if regular online assessments improved the overall academic performance of medical undergraduate students.