Abstract
This article was migrated. The article was marked as recommended. The COVID-19 pandemic has brought many challenges to medical education, necessitating a rapid transition to digital delivery. The widespread move to online exams has introduced novel risks, including the risk of catastrophic IT failure. These are not 'black swan' events - something so unexpected and devastating that we could not anticipate them and prepare accordingly. The phrase 'black elephants', a cross between a black swan and 'the elephant in the room' has been coined to describe these events. Moving to high-stakes online examinations introduces another element that needs to be considered and managed: the 'stability' of the assessment format used. This dimension incorporates notions of 'platform reliability' and 'internal risk management' and can be caused by both unplanned events eg IT failures, and planned events like security breaches Developing approaches to mitigate this new risk suggests another dimension to the well-known assessment 'utility equation': stability of the platform used. This paper explores the concept of stability from the perspectives of educational institutions and candidates and offers some approaches to achieving stability. The delivery of assessment in the digital age, requires the 'utility equation' to be recalibrated and establishment of a new "sweet spot" for each assessment program.
Highlights
COVID-19 has affected every aspect of life globally since 2020
It has necessitated a rapid transition to digital delivery which introduces novel risks, encapsulated in the proposed dimension of "stability." While online exams minimise travel time and costs for candidates, examiners and staff, these benefits are to some degree balanced by an increase in costs in terms of platform, infrastructure, administration and need for risk mitigation
For an antifragile educational organisation, this moment in history presents an opportunity for clinical assessment to transition away from the traditional event-based examinations to programmatic models of assessment utilising real-time and longitudinal data collection closer to the source of clinical practice enabled by the necessary use of technology (Taleb, 2012)
Summary
COVID-19 has affected every aspect of life globally since 2020. Medical education has not been immune. The ‘Stability’ of an online assessment approach relates to the reliability of the educational design and platform used (‘not changing or being upset’), and represents a form of internal risk management to ensure secure administration of the exam to all candidates. The recent trainee forum communique made further recommendations about a number of responses including: trainee support; the maximum allowable time of delay before adopting the backup exam modality; rescheduling exams; refunds and managing costs associated with re-sits; personalized support for each candidate to prioritize trainee wellbeing; provisions for additional training time and examination leave; and independent investigation into the cause of any disruption (Australian Medical Association, 2020) These are all important considerations in formulating a plan to manage stability of an assessment program. We have all grown accustomed to uncertainty – and to doing things in different ways, often without the need to travel
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