Ali Sana, Ali Syed Muhammad Hammad, Saeed Hamayle, Chaudhry Minahil Fatima, Khalil Javed, Ahsen Noor Fatima
Department of Obstetrics and Gynecology, James Cook University Hospital, Middlesbrough, GBR.
Department of Medical Education, University of Central Lancashire, Preston, GBR.
Cureus. 2025 May 20;17(5):e84480. doi: 10.7759/cureus.84480. eCollection 2025 May.
Background Remote online assessment (ROA) systems gained prominence in undergraduate medical education during the COVID-19 pandemic. This study describes a uniquely phased implementation of an ROA system in a resource-limited setting, guided by an analysis of student satisfaction and perceptions. Methodology This observational study presents data from the implementation of ROAs at a private medical school in Lahore, Pakistan. Four principal activities were conducted on five undergraduate medical and four dental program classes, including two mock and two summative assessments. The ROA system utilized open-source, web-based software to administer the assessments. Primary outcomes included the rate of uninterrupted exam completions and student satisfaction (measured on a five-point Likert scale) during the first three activities. Secondary outcomes examined perceptions of educational impact, perceived usefulness, and the effectiveness of anti-cheating measures. Results Over 800 students participated in the ROA implementation process. Clinical-year students reported significantly higher levels of satisfaction compared to preclinical students (mean ranks = 443.18 vs. 372.81, 454.31 vs. 409, and 435.50 vs. 380.13, p < 0.05), while female students consistently reported lower satisfaction. One-on-one online training sessions conducted in small groups and mini-mock exams significantly improved overall satisfaction (p < 0.005). Key challenges included insufficient exam time (n = 614, 73.9%) and internet connectivity issues (n = 470, 57%). Although live proctoring effectively deterred cheating, it also heightened exam-related anxiety (n = 313, 77.9%). Despite perceiving ROAs as inferior to traditional examinations, students acknowledged their value in supporting course completion and preparation for summative assessments. Conclusions A phased, adaptive approach is essential for implementing ROAs in resource-limited settings. Repeated mock exams, small-group training, and targeted support for preclinical and female students can improve satisfaction and program outcomes. Addressing technical and psychological barriers is critical to successfully integrating online assessments into undergraduate medical education.
在2019年冠状病毒病大流行期间，远程在线评估（ROA）系统在本科医学教育中得到了广泛应用。本研究描述了在资源有限的环境中，在对学生满意度和看法进行分析的指导下，ROA系统独特的分阶段实施情况。
本观察性研究展示了在巴基斯坦拉合尔一所私立医学院实施ROA的数据。对五个本科医学课程班和四个牙科课程班开展了四项主要活动，包括两次模拟评估和两次总结性评估。ROA系统利用开源的基于网络的软件进行评估。主要结果包括在前三项活动中不间断考试完成率和学生满意度（采用五点李克特量表测量）。次要结果考察了对教育影响、感知有用性和防作弊措施有效性的看法。
超过800名学生参与了ROA实施过程。临床年级学生报告的满意度显著高于临床前学生（平均秩次分别为443.18对372.81、454.31对409、435.50对380.13，p<0.05），而女生报告的满意度一直较低。以小组形式进行的一对一在线培训课程和小型模拟考试显著提高了总体满意度（p<0.005）。主要挑战包括考试时间不足（n = 614，73.9%）和网络连接问题（n = 470，57%）。尽管实时监考有效地阻止了作弊行为，但也加剧了与考试相关的焦虑（n = 313，77.9%）。尽管学生们认为ROA不如传统考试，但他们承认其在支持课程完成和总结性评估准备方面的价值。
在资源有限的环境中实施ROA，分阶段、适应性的方法至关重要。重复进行模拟考试、小组培训以及对临床前学生和女生的针对性支持可以提高满意度和课程效果。解决技术和心理障碍对于成功将在线评估整合到本科医学教育中至关重要。
