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During the pandemic, written exams were replaced with oral digital exams. The number of questions was scaled down from 125 to 15. Students were given 20 minutes to answer.
During the pandemic, written exams were replaced with oral digital exams. The number of questions was scaled down from 125 to 15. Students were given 20 minutes to answer.

Students achieved good exam results during the pandemic

Creating a fair exam system for second-year medical students during the pandemic was quite a challenge. A study now shows that it was successful.

From March 2020 to the beginning of 2022, medical students were taught theoretical subjects digitally, to a large extent. 

The question the researchers asked themselves in this study was whether the students would have knowledge gaps and fare worse than those who studied medicine before the pandemic. The students completed four exams in physiology during this period. A total of 1,095 medical students were included in the study. 

“It does not appear that they lack any knowledge. Quite the contrary. This is good news for the students, their teachers, and leaders. Since we are talking about future doctors, it's good to know that the quality of the teaching was satisfactory, at least in the case of second-year physiology,” Kåre-Olav Stensløkken says.

He is a professor at the University of Oslo's Institute of Basic Medical Sciences. He led the study and the examination commission during this period.

They had to make sure that the system was fair

Stensløkken believes that the good results are due to a rapid change in tuition and that thorough and good efforts were made to ensure that exams were held in a fair manner. 

He points to the important work carried out by the examination commission and Stefan Schauber in regards to quality assurance. Schauber is an associate professor at the Unit for Health Sciences Education.

From left: Stefan Schauber and Kåre-Olav Stensløkken.

“The aim was that the system should be fair, both for the students taking the exams at the time and in relation to students from earlier study years. No cheating should be possible. The fact that this work has become the subject of an article is well deserved and the result of good work carried out by the many involved parties,” Stensløkken says.

The quality assurance work paid off

“The challenge was to compare what happened during this period with the years before the pandemic because key elements had been changed: the teaching and the exams. We had access to a good supply of earlier exams, where errors had already been weeded out by previous quality assurance work,” Schauber says.

An important piece of background information for the study was to know which exam questions primarily tested basic knowledge and which singled out the strongest candidates.

“Work done earlier made this easier. This shows the importance of evaluating exams on an ongoing basis. It is well worth the effort,” he says.

Changed from a written paper to an oral exam

One of the reasons why the change was so great was that a written exam requiring the physical presence of the candidates had to be changed to an oral exam conducted via Zoom. 

The number of exam questions and the amount of time allotted was greatly compressed. 

The written exam normally lasts five hours and includes around 125 multiple-choice questions. For the oral exam, this was scaled down to 15 questions which the students were to answer in just 20 minutes.

The examiners could ask additional questions

In normal circumstances, grades are given for exams, but the exam during the Covid-19 pandemic was graded as pass/fail.

Since there were fewer exam questions, a special system was developed in order to determine borderline pass/fail cases. 

The students who were near to failing were given three additional questions which they could answer by talking freely. The examiners were provided with guidelines indicating the points that these students had to mention in order to achieve a pass, and they had to pass a minimum of two of the three questions.

Magnus Løberg, pro-dean of studies, is also pleased with the study:

“A key reason why the students have managed so well during the pandemic is also that we have very clever and highly motivated medical students who manage to adapt to new situations. I applaud Stensløkken for taking the opportunity to devise a study for charting students’ achievements,” he says.

Stensløkken points out that even though the findings are positive, this does not mean that we can argue that digital tuition is better than normal teaching methods.


Schauber, S.K. & Stensløkken,K-O. No knowledge gap in human physiology after remote teaching for second year medical students throughout the Covid-19 pandemicBMC Medical Education, vol. 23, 2023. DOI: 10.1186/s12909-023-04959-x

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