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Int J Emerg Med. 2010 Feb 5;3(1):21-6. doi: 10.1007/s12245-009-0147-2.

Learner perception of oral and written examinations in an international medical training program.

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Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.



There are an increasing number of training programs in emergency medicine involving different countries or cultures. Many examination types, both oral and written, have been validated as useful assessment tools around the world; but learner perception of their use in the setting of cross-cultural training programs has not been described.


The goal of this study was to evaluate learner perception of four common examination methods in an international educational curriculum in emergency medicine.


Twenty-four physicians in a cross-cultural training program were surveyed to determine learner perception of four different examination methods: structured oral case simulations, multiple-choice tests, semi-structured oral examinations, and essay tests. We also describe techniques used and barriers faced.


There was a 100% response rate. Learners reported that all testing methods were useful in measuring knowledge and clinical ability and should be used for accreditation and future training programs. They rated oral examinations as significantly more useful than written in measuring clinical abilities (p < 0.01). Compared to the other three types of examinations, learners ranked oral case simulations as the most useful examination method for assessing learners' fund of knowledge and clinical ability (p < 0.01).


Physician learners in a cross-cultural, international training program perceive all four written and oral examination methods as useful, but rate structured oral case simulations as the most useful method for assessing fund of knowledge and clinical ability.


Assessment tools; Curriculum development; Graduate medical education; International medical education; Oral case simulations

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