Journal Article
. 2021 May; 8:23742895211013533.
doi: 10.1177/23742895211013533.

Pathology Resident Evaluation During the Pandemic: Testing and Implementation of a Comprehensive Online Pathology Exam

Susan M Armstrong 1 Paula Nixon 1 Carlo V Hojilla 1 
Affiliations
  • PMID: 34027056
  •     17 References

Abstract

Despite global digitization, evaluating pathology trainees by paper exams remains the norm. As new social distancing practices require new ways of administering exams, we assessed the viability of an online format for in-house exams from the resident and examiner perspectives. First, pathology residents participated in a practice exam, while staff who were experienced in creating exams were given an online exam-creation demonstration. Subsequently, residents completed a formal 3-hour online exam comprised of multiple-choice, matching, short answer, and whole slide images in place of the paper exam regularly used to evaluate trainees. The experience of the participants was evaluated by surveys. Eighteen residents completed the practice exam; 67% were receptive to the new format and 94% were in favor of moving to digital exams. Seven staff evaluated the digital format and 6 were in favor of it. For the formal online in-house exam, 20 residents participated and 14 completed the survey. Feedback was generally positive with the most common issue being slow-loading digital slides. Exam scores stratified by postgraduate training years in a statistically significant manner, showing positive correlation with resident training level. The online exam format was preferred over paper exams by trainees, with support from both staff and trainees for a permanent transition. Online exams have clear advantages, but technical issues should be addressed before widespread implementation. Our study demonstrates that online exams are a feasible alternative for trainee assessment, especially in socially distanced environments.

Keywords: digital pathology; exam design; online exam; resident education; social distancing.

Medical assessment in the age of digitalisation.
Saskia Egarter, Anna Mutschler, +2 authors, Konstantin Brass.
BMC Med Educ, 2020 Apr 03; 20(1). PMID: 32234051    Free PMC article.
Evaluating the usefulness of computerized adaptive testing for medical in-course assessment.
C D Kreiter, K Ferguson, L D Gruppen.
Acad Med, 1999 Oct 28; 74(10). PMID: 10536635
Introducing Computer-Based Testing in High-Stakes Exams in Higher Education: Results of a Field Experiment.
Anja J Boevé, Rob R Meijer, +2 authors, Roel J Bosker.
PLoS One, 2015 Dec 08; 10(12). PMID: 26641632    Free PMC article.
The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis.
Min Luo, Lixia Guo, +2 authors, Haiyan Wang.
Psychiatry Res, 2020 Jun 22; 291. PMID: 32563745    Free PMC article.
Systematic Review.
Moving a formative test from a paper-based to a computer-based format. A student viewpoint.
Joy R Rudland, Peter Schwartz, Anthony Ali.
Med Teach, 2011 May 20; 33(9). PMID: 21592016
Computer Based Assessment (CBA): Perception of residents at Dow University of Health Sciences.
Masood Jawaid, Foad Ali Moosa, Farhat Jaleel, Junaid Ashraf.
Pak J Med Sci, 2014 Aug 07; 30(4). PMID: 25097497    Free PMC article.
Teaching pathology via online digital microscopy: positive learning outcomes for rurally based medical students.
Sundram Sivamalai, Shashidhar Venkatesh Murthy, Tarun Sen Gupta, Torres Woolley.
Aust J Rural Health, 2011 Jan 27; 19(1). PMID: 21265925
Implementing a structured digital-based online pathology curriculum for trainees at the time of COVID-19.
Simon F Roy, Matthew J Cecchini.
J Clin Pathol, 2020 May 06; 73(8). PMID: 32366598
Review.
Evaluation of performance and perceptions of electronic vs. paper multiple-choice exams.
Shannon Washburn, James Herman, Randolph Stewart.
Adv Physiol Educ, 2017 Oct 27; 41(4). PMID: 29066605
Perceptions and performance using computer-based testing: One institution's experience.
Timothy J Bloom, Wesley D Rich, Stephanie M Olson, Michael L Adams.
Curr Pharm Teach Learn, 2018 May 01; 10(2). PMID: 29706282
A study of student performance on self-scheduled, computer-based examinations in a medical histology course: is later better?
E Robert Burns, Judith E Garrett, Gwen V Childs.
Med Teach, 2007 Dec 26; 29(9). PMID: 18158680
An Analysis of the Effect of the COVID-19 Pandemic on Case Volumes in an Academic Subspecialty-Based Anatomic Pathology Practice.
John H Sinard.
Acad Pathol, 2020 Oct 23; 7. PMID: 33088911    Free PMC article.
Virtual microscopy and digital pathology in training and education.
Peter W Hamilton, Yinhai Wang, Stephen J McCullough.
APMIS, 2012 Mar 21; 120(4). PMID: 22429213
Review.
Computer versus paper--does it make any difference in test performance?
Yassin Karay, Stefan K Schauber, Christoph Stosch, Katrin Schüttpelz-Brauns.
Teach Learn Med, 2015 Jan 15; 27(1). PMID: 25584472
Using computers for assessment in medicine.
Peter Cantillon, Bill Irish, David Sales.
BMJ, 2004 Sep 14; 329(7466). PMID: 15361445    Free PMC article.
Review.
Systematic Review of Computer Based Assessments in Medical Education.
Saad Al-Amri, Zahid Ali.
Saudi J Med Med Sci, 2016 May 01; 4(2). PMID: 30787703    Free PMC article.
Review.
Use of whole slide imaging (WSI) for distance teaching.
Andrew John Evans, Nadia Depeiza, +3 authors, Runjan Chetty.
J Clin Pathol, 2020 Jul 11; 74(7). PMID: 32646928
Review.