Structured Oral Examination
Dr. U. K. Taufiqun Nessa
Associate Professor &Head
Department of Community Medicine
Mymensingh Medical College.
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Oral Examination
 An Oral Examination may be defined as an
exam consisting of a dialogue with the
examiner, who asks questions to which the
candidate must reply.
 Used to probe more deeply a student’s ability
to think and to express more of less clearly
his knowledge.
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Oral Examination……….
 It takes the form of series of interrelated
questions.
 Helps to assess other competencies such
as communication skills and professional
attitudes
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Traditional Oral Examination
 Usually a subjective test; at times, it can be
intimidating to the students
 “It may be formidable even to the best prepared
for the greatest fool may ask more than the
wisest man can answer”-Charles Colton
 Often fails to assess properly the cognitive and
problem solving skills which is mainly aimed at in
oral exam.
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Traditional Oral Examination
In TOE, the atmosphere of the exam is
often threatening & at times, the
dialogue takes the shape more of
confrontation than co-operation
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What is being measured in the Traditional
Oral Exam?
In an observational study of a Board
Examination, it is found that70 % questions required recall of facts,
<20 % ........................ interpretative skills
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What is being measured in the Traditional Oral
Exam?.........
 13% ........................... problem solving ability
McGuire.
 So serious doubts exist about the oral exam
of current practice regarding its ability to
measure the high cognitive skills of a
candidate.
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How reliable and valid-the Traditional
Oral Exam?
In part these depend on the observed
agreements between two or more sets
of grades assigned by independent
examiners
Independent marking by a pair of
examiners is rarely done
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How reliable and valid-the Traditional
Oral Exam?...
 One examiner usually announces the grade
and the other either agreed of disagreed
producing spuriously high agreement.
 Comparison between grades of oral exam
and marks on written exam and marks on
written exam have low correlation coefficients
indicating low Reliability or Validity of oral
exam.
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Demerits of Traditional Oral Exam
It lacks standardization, objectivity and
reliability of results.
Possibility of abuse of personal contact
There may not be enough adequately
trained examiners.
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Demerits of Traditional Oral Exam…….
Expensive in terms of professional time
and information yield
Language barrier may be a factor for
poor performance
Test questions and the student
responses go unrecorded.
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How can the oral exam be improved?
 Possibly, the answer is, by organizing the
oral examination in a structured manner
 By structuring the oral exam, it is possible to
elicit from the students their cognitive,
Problem solving, interpretative and decision
making skills.
 And ensuring higher degree of validity,
reliability and objectivity
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How can the oral exam be structured?
Various elements of oral exam may be
organized taking in to accounts the rules
The Examiner
Careful selection of examiners
Paring a new examiner with a more
experience person
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How can the oral exam be
structured?..........
Briefing sessions for the examiners
Providing the examiners with written
instructions regarding the content
area to be covered and the nature of
competence to be measured.
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How can the oral exam be structured
?…
 Atmosphere
 Creating a non threatening environment.
 equal duration of time for each candidate
 Starting with, easy topic, then proceeding to
more difficult problems
 Shifting the topic if someone fails to answer
in one area
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How can the oral exam be structured?
…
 The Questions
 The questions constructed by a group of
faculty with inputs from all those who have
participated in the teaching process.
 A number of questions from each topic
covering the content area of varying difficultly
among the learning objectives
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How can the oral exam be structured?
…
 The questions are then framed some to
assess recall, but most to assess their
problem solving abilities.
 Most correct answers for each question are
decided in advance.
 Marks allocated for each parts of question,
weight age being for different level of
difficultly
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How can the oral exam be structured?
………
 Each question is typed on a card and put in
boxes of defined domain.
 A number of questions are made for every
topic and collected together
 Make a large series of cards, each card write
one question carefully worded.
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How can the oral exam be structured?
………
 (Check the wording by reading the question
to your colleagues and to make sure the they
understand the question as-you intended).
 Divide the cards into groups. Each group is
representing one section of the course.
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The Examination Process
The candidate randomly selects on
card from each box and answer.
The examiner reads the question,
repeat if necessary or the candidate
reads the question if allowed.
No cues or clues are provided.
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The Examination Process…
After the candidate answer the questions
the examiners place a tick in an
appropriate box on a prepared rating
scale.
There is a scoring related to the
boxes.
If failure answer the first question, no
further chance in that area.
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The Examination Process …
The examiners should not indicate
whether the student answers correctly
or not
Each examiner should have equal
time, each marking individually and
scores are averaged.
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The Examination Process …
 Each question may be marked individually
and summing up at the end.
 Questions, answers and scores are noted
concurrently by the examiners for each
candidate-this will help in the feed back
session
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Model questions…
Taking an example of Malaria as a problem
-The student must know the treatment of
malaria at different ages (recall of dosages
of anti-malarial drugs).
-Must be able to deal with an individual having
fever which may be of malaria origin
(problem solving).
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Model questions…
The student’s knowledge on these aspects can be
assessed by question like:
a. Define presumptive treatment in malaria.
b. What are the drugs used for presumptive treatment
c. Under the National Malaria Eradication Programe,
What presumptive treatment is prescribes to a 9
year old child?
These questions are basically testing the recall of
knowledge.
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Model questions…
It may also be presented as a problem followed
by questions e.g. A 10 year old boy is
brought to the village health guide with
fever of acute onset.
•
•
•
What does he do?
What type of surveillance is he carrying out?
As the medical officer in-charge of the PHC what
action will you take?
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Model questions…
This question requires both recall of knowledge
and problem solving skills.
Each question usually has two to three parts.
An attempt is made to increase the level of
difficulty in each part. For Example:
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Model questions…
A woman wants to use oral contraceptives for
spacing her family.
a. How will ensure that she is eligible?
You have found that she is eligible for oral
contraceptives.
a. Explain her the procedure for use.
b. What are the side effects of oral
contraceptive?
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Feed Back Session
 Students feed back is always an important aspect of an
assessment. This is very much possible SOE
 Students are individually appraised about the response
to a particular question
 Question, answers and scores are noted by the
examiners for each candidate, so that they can be
informed where they scored and where they did not well.
 Students do come back to find out the lacunae in their
knowledge or how to answer certain questions.
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Validity, Reliability and Objectivity
of SOE
 The outlined scheme makes the oral test more
objective and structured, thus imparting higher
degree of validity and reliability
 Objective- because the candidate selects his or
her questions, so examiners whim or biases are
obviated. Concurrent marking ensures that the
examiner does not make an over all assessment
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Validity, Reliability and Objectivity
of SOE .
Structured- because the questions are
prepared in advancements the
educational objectives and clearly
define the intellectual level being
assessed.
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CONCLUSIONS
 Conducted properly, oral examinations are a
useful component of assessment. It
inculcates in the students, the faculties of
thinking fast, clear expression and intellectual
honestly
 It has a special place in medical education
because the competence of a doctor is judge
by his patients so frequently from the way he
talks.
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