Evidence-based operational model for conducting an online, synchronous, proctored, closed book professional examination during the COVID-19 pandemic lockdown

Background: Medical education has migrated online as a result of the COVID-19 pandemic. Formative and summative evaluation are critical in medical education to support the learning process. However, many problems occur during online assessment, such as internet access, proctoring, and reliable software. To mitigate this situation, there is presently no standardised model available that demonstrates reliability and validity, particularly when it involves high-stake examinations. The goal of this study was to introduce an evidence-based operational model that was used to conduct a comprehensive high stake online examination to Year 2 MBBS students during the COVID-19 pandemic. Prior to entering the clinical years (year 3-5), year 2 MBBS students were expected to pass their high-stake examination earlier conducted as face-to-face session which is now administered online. Methods: The model proposed enables the conduct of an online, synchronous, proctored, closed-book examination in real-time that is comparable to the face-to-face (FTF) manual examination. The examination and invigilation were carried out using the Learning Management System (LMS) and Google Meet applications with the existing information technology (IT) facilities and the Standard Operating Procedure (SOP) was developed to optimise and integrate the technology effectively. Results: Both students and faculty were satisfied with the online examination, with the latter being more so. The online examination with a Cronbach alpha score of 0.71 suggested good internal consistency and reliability and various test of validity ensured this online model was dependable, reproducible and concurrent with other examinations. Conclusions: We concluded that this operational model is a credible alternative to the FTF examination that requires new learning technology and is very cost effective. Thus, we highly recommend this model for all examinations that involve participation of off campus students.