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. 2021 May 11:8:23742895211013533.
doi: 10.1177/23742895211013533. eCollection 2021 Jan-Dec.

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   2
Affiliations

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

Susan M Armstrong et al. Acad Pathol. .

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.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Screenshot from exam created using Tutor platform. Whole slide image is seen on the right-hand side of the screen. The question is on the upper left. Thumbnails on the lower left show the whole slide images that are associated with the question and available to be viewed. The thumbnail that is selected is outlined in red.
Figure 2.
Figure 2.
Screen shot from the quiz creation page of Quercus.
Figure 3.
Figure 3.
Screen shot from a whole slide image (WSI) from the Digital Laboratory Medicine Library (DLM). This screenshot was included with permission from the Department of Laboratory Medicine and Pathobiology at the University of Toronto.
Figure 4.
Figure 4.
Staff responses when asked: (A) how user-friendly Tutor is for entering questions, (B) how user-friendly Quercus is for entering questions, and (C) how writing an exam online compared to writing an exam using the paper-based format.
Figure 5.
Figure 5.
Resident responses related to the practice exam when asked how the online format compared to the written format.
Figure 6.
Figure 6.
Resident responses comparing the formal in-house online exam to different aspects of previous paper-based exams.
See this image and copyright information in PMC

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