Table 4. Themes of the strengths and weaknesses of the traditional oral examination and the standardized oral examination
Themes Traditional oral examination* Standardized oral examination
Strengths Examples of faculty comments The ability of assessing students’ reasoning skills “Oral exams allow you to assess their (students’) reasoning and communication skills, and to converse with them.” “I believe the oral exams prepare students for clinical reasoning needed to practice medicine.” Demonstrates students’ learning “Gives students an opportunity to show their skills in a different and more "applicable" way.” “They (students) present their own cases and are usually knowledgeable about the case.” Uniformity “Consistency in general clinical knowledge assessment.” “Uniform question list for representative cases that allows more direct comparison of examinees’ knowledge base” Fairness “Keeps the examiner grounded as to the level of knowledge and reasoning that should be expected for a medical student. Fairness.” “Improves examiner organization and consistency. Standardization attempts to eliminate unconscious bias and allows there to be a system of fair and equitable evaluation.” Easy to use “Helps less experienced faculty examiners administer the oral exam more easily.”
Weaknesses Examples of faculty comments No grading standards “Somewhat subjective” “Grading sometimes seems to vary among examiners” “Lack of standardization” Strong individual variations “Variation in examiner skills, biases and techniques.” “The variability in each student’s case list and presentation.” Time pressure “I think it takes a lot of time, which is something most of us have little of.” “Takes students away from the wards an additional 2-3 hours per block” Inflexible “The standardized questions aren't always appropriate for the case the student has listed.” “At times the students’ choice of patient does not quite fit into the category of questions so I end up not completely sticking to the standardized questions.” “The flow of the oral exam as a "conversation" is made more challenging by the standardized questions -- this is a minor weakness.” The ability of assessing students’ higher order reasoning skills by having to focus on standardized questions “Focusing on standardized questions left less opportunity to assess (students’) higher-order clinical reasoning.”

*Faculty comments from pre-implementation survey; ¶Faculty comments from post-implementation survey.

Int J Med Educ. 2018; 9:255-261; doi: 10.5116/ijme.5b96.17ca