A Quasi-Experimental Study on the Impact of Blended Assessment on Performance and Anxiety Levels of Otorhinolaryngology Clinical Interns.

Abstract

Objective: Traditional assessments for otorhinolaryngology clinical interns primarily rely on closed-book examinations (CBE) to evaluate foundational knowledge and reinforce long-term retention. This quasi-experimental study investigates the impact of a blended assessment model-integrating both open-book and closed-book components-on academic performance, test anxiety, and preparation time, compared to the conventional CBE approach.

Methods: A total of 240 medical students from the 2019 (CBE, n = 115) and 2020 (blended assessment, n = 125) cohorts at the Third Affiliated Hospital of Sun Yat-sen University were enrolled. Exam scores, preparation time, test format preferences, and Revised Test Anxiety Scale (RTA) scores were collected and analyzed. Statistical comparisons between the 2 groups were performed.

Results: All 240 participants (123 males and 117 females) completed the study, achieving a 100% participation rate. No significant differences were found between the CBE and blended assessment groups in academic performance (P = .906) or anxiety levels (P = .411). However, the blended assessment group reported significantly longer preparation times (P = .027). RTA scores were not significantly correlated with gender (P = .416), exam scores (P = .282), or preparation time (P = .410), though female students exhibited slightly higher anxiety levels. Regarding exam format preferences, 19.2% of students favored CBE (70.8% female), while 80.2% preferred open-book exams (43.6% female).

Conclusion: The blended assessment model, incorporating both CBE and open-book examinations, serves as a feasible alternative for evaluating clinical interns, fostering their problem-solving abilities. While it demands increased preparation time, it is well-received by students and holds promise for broader adoption in medical education.