Online exams vs in person – what’s better?

This term was my first time writing med schools exams in person. Which, understandably, are a little different from writing online exams. I’ve talked about how online vs in person classes compare. So after completing my first in-person term, it’s only fitting that I talk about the differences between online exams vs in person exams in med school.

Written online exams vs in person

In person exams are typically 140-150 questions and we have around 3.5 hours to complete them. We have an assigned seat for each exam in one of the 2 testing buildings on campus. There’s a 30 minute window to check into the exam area. At the designated start time, the exam password is announced. And then we can start.

We can bring a clear water bottle into the exam. And we can get up for bathroom breaks. But the timer on your exam keeps going so you need to be quick.

We use the same exam software as last term. However, there’s no longer any audio & video recording of us. And that’s because we have exam proctors in the hall.

And the biggest difference is that our exams are not divided into blocks. For the online exams, each block was about 50 questions and we had 70 minutes to complete it. We received the exam password in an email, 15 minutes before each block. Then we’d begin at the designated start time.

During the exam, the software made an audio and video recording to ensure there was no cheating. If our eyes moved off screen or there was excessive movement, the software would flag us. And then the recording was reviewed to determine if the student was cheating.

There was a 45 minute break between each exam block. Which was nice because you could use the bathroom or have lunch. But it also meant that we didn’t finish until 3:30 ish.

With in person exams, we start at 8:30 and finish by 12pm at the latest. So you have the entire day to relax and do whatever you want. But it’s quite tiring to do 150 exam questions straight.

Online lab exam vs in person

For the in person lab exam, we had 25 stations and 82 seconds at each to identify the labeled item or it’s function/innervation/lymphatic drainage. It was multiple choice, so we’d fill in our answer on a scantron (never thought I’d use that again).

Most of the stations had cadaveric specimens. And a few stations had medical images, so an x-ray or MRI. Either way, all the questions were either first or second order.

There were 3 circuits that each had the same 25 stations. And there was 1 student on either side of the station. So every 82 seconds, the timer would go off and everyone would move to the next station. And 6 new students entered the lab and started the exam.

About 2 weeks before the exam, they did a test run with only 10 stations. I’m glad they did that because seeing the setup eased some of my stress.

Last term, the online lab exam also involved the same style of 25 questions. Just like the in person exam, there was a mixture of cadaver and medical images. The difference is that we did them electronically.

Seeing the cadaver up close was helpful for the really obscure questions. Sometimes you really had to inspect the cadaver to orient yourself. And that’s not something we could do with the 1-D image on our screen during the online exam.

However, the wait time to get into the lab was inconvenient. Especially because you can’t have your phone or study in the sequestration area. The exam itself was about 34 minutes. But because of the wait time, it took me about 1.5 hrs to be in the clear. And I was lucky to be part of one of the earlier groups that could enter. It took about 3 hours to complete for the students in the latest group.

OSPE online exam vs in person

For the in person OSPE exam, we had to perform various physical tests during 4 simulated patient encounters.

Like the lab exam, we reported to a sequestration area before the exam. And a group of students continuously entered the testing building.

Once in the building, we signed in at each station using our student credentials. Then we had 2 minutes to read the instructions on the door of the exam room. For example, the scenario might describe an elderly patient with hearing problems over the last several months. And the instructions would be to perform the Weber and Rinne hearing tests.

After 2 minutes, there was an announcement that the patient encounter had begun. So we entered the exam room and had 5 minutes to complete the exam. There was an examiner in each room who assessed our performance.

Last term, the online OSPE exam was just a multiple-choice test. We had scenarios about the patient’s presenting symptoms and had to identify the appropriate exam to administer. Or select which step would come next.

Although it was stressful, I enjoyed doing the OSPE exam in person. Albeit it was simulated, it was satisfying to experience a patient encounter. It was a nice reminder that what we’re learning in class has an application in the patient setting.

And more than that, I enjoyed the process of learning and getting better at administering the patient exams. Where in the beginning I was just fumbling to find the words to explain to my patient what I’d be doing. And to remember the steps involved in the encounter. Yet by exam time, I was so much faster at administering all the tests. After all the practice, I didn’t have to think too much about what I was doing. So the whole process flowed more naturally.

Seeing that growth over a few weeks was very satisfying. And it was another reminder that we can get better at anything with continued practice.

Takeaways

So those are some differences between online exams vs in person in med school. Overall, I prefer in person exams. I just wish the wait times before exams were shorter.

Do you prefer online or in person exams?

-M

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