Effectiveness of the Structured and Conventional Methods of Viva Examination in Medical Education: A Systematic Review and Meta-analysis

Introduction: Oral examination (viva voce) is one of the common assessment methods for medical students. Literature shows that Conventional Oral Examination (COE), is a widely adopted method and uses a consolidated scoring system. There came an alternative method, Structured Oral Examination (SOE) that uses the recommended rating scale (prevalidated questions and markings). The emergence of a new method raised the research question of whether the conventional or structured oral examination is effective in assessing medical students. Aim: To evaluate the effectiveness of traditional and structured viva-voce examination across the specialties in medical education. Materials and Methods: A systematic review was conducted on 18 peer-reviewed articles about conventional and structured oral examination among medical students. Medical Education Research Study Quality Instrument (MERSQI) was used to assess the quality of evidence. Results: The level of evidence was moderate where the MERSQI score ranges from 7.5 to 15.5 for the 18 articles included in the review process. SOE overcomes COE by assessing students' cognitive skills, communication skills, behaviour, and attitude whereas COE principally assesses the recall knowledge. Analytical and reasoning power remains the predominant domain in SOE. With psychometric properties like good reliability, sensitivity, and acceptability, SOE remains the best strategy for the evaluation of medical students. Pooled results in the forest plot showed no difference in the viva voce marks between COE and SOE with a mean difference of 0.46 (p=0.53). Conclusion: The review analysis revealed that there is no difference in the mean marks scored by COE and SOE. However, a SOE will allow examiners to assess the medical students' learning achievement with no partiality, stress, and anxiety compared to COE.