Effects and sustainability of trainings for the oral and practical part of the German final exam in medicine.

Study goals: It is known that the manifold limitations of oral and practical examinations can be improved by specific training. With the help of an online survey, our present study analyzes the effects that can be achieved by the training conducted at the University of Ulm for examiners in the final medical examination, the long-lasting impact of the training, and differences among participant subgroups.

Method: All 367 participants in the training at Ulm (2007- 2012) were contacted via email. Sixty-three persons responded to the survey that included 28 items concerning demographic data, effectiveness, and sustainability.

Results: Six main effects of the training were identified (meaning effects rated with a grade of 1 or 2 on a 6-point scale by two thirds of the participants, with 1="applicable" and 6="not applicable"; cumulated percentage of answers of 1 or 2 in parentheses): 1. Conscious handling of strengths and weaknesses of oral examinations (71%), 2. Knowledge of factors contributing to the reliability of oral/practical examinations (76%), 3. Knowledge of factors contributing to the validity of oral/practical examinations (75%), 4. Improvement of competence in task construction (68%), 5. Improvement of competence in respect to examination formalities (75%), 6. Implementation of the concept of "structured oral examinations" (a priori planning of examination subjects, tasks, levels of expectation and grading criteria) (86%). The responses of participants trained more than two years ago were not significantly different from the answers given by recently trained persons. This is an argument for the sustainability of the training effects. Furthermore, participants without relevant prior experience in oral/practical examinations profited significantly more from the trainings, especially in the areas of stress reduction, confidence in grading, and competence in critical discrimination of grading.

Conclusion: The positive and sustained effects of the examiner training argue for continuing the training program, especially for inexperienced examiners. Expansion of the successful training program to include the first medical exam should be considered.