1. Structured Oral Viva Dr Gauravi A. Dhruva Prof. & Head
Department of Pathology
P. D. U. Medical College, Rajkot

2. Objective Abilities that can be tested —Classification Structure
—Merits and Demerits
Strategies to improve

3. What is an oral assessment?
Direct means of assessing students’ learning outcomes by questioning them
— ‘Oral assessment’ includes any assessment of student learning that is conducted,
wholly or in part, by word of mouth

4. Purpose
Tests mainly Cognitive domain of the student, but can include affective or communication
Memory(depth of knowledge)
Understanding of the subject
Reasoning and problem solving
Communication skills
Ability to perform under stress
Professional competence

5. Types of oral assessments
1. Oral assessment after a direct observation assessment
— part of a de-briefing session after a practical has been observed.
—time duration:3-5 minutes.
usually no formal structure
ask questions as examiner foresee
however, assessors may plan some general questions for all.

6. Types of oral assessments
2. Oral in the form of a viva voce
— Latin name for oral examination
—often given for a university examination with spoken questions and answers
Usually PG level, after the submission of the thesis
Vivas are traditionally conducted by an external and an internal examiner
no set time limit

7. Types of oral assessments
3. Oral/Aural in a language setting
Oral
is a direct speaking test assessing a student's level of speaking proficiency.
Aural
is a listening test assessing a student's level of hearing proficiency.

8. Types of oral assessments
4. Miscellaneous:
— Table Viva
— Long case
— Short Case

9. Structure of an oral assessment
Depends on type of oral assessment, but in general, the followings are used.
Allow the student to start
His spontaneous account can reveal far more than simply responses to the questions.
Questions such as:
How do you think you did?
What is the probable diagnosis according to you?

10. Structure of an oral assessment
Probing questions - to initiate and engage.
Questions such as:
How did you know that?
What method did you use to arrive with that conclusion?

11. Structure of an oral assessment
Prompting questions – give hints
Questions such as:
Remember the experiment on xyz?
What do you think this relates to?
Structures in right hypochondrium (related to the liver)

12. Structure of an oral assessment
Challenging questions – to assess deep understanding - higher level of Blooms taxonomy.
Questions such as:
Can you justify why your method is more efficient than Prof. Einstein’s?
Why should I consider your diagnosis?

13. Validity Assessment is valid when
it allows students to fully demonstrate their knowledge, skills and values
in relation to the course they are studying.
Several types of validity that can throw light on the quality of oral assessment.

14. Reliability
When a student has completed an oral assessment, can we be confident that
he or she would do equally well if they were asked other questions?
Given a different scenario to respond to?
Assessed by another colleague?
Assessed at another time?

15. MERITS

16. Merits Direct personal communication Assesses personality and aptitude
Circumstantial factors
Flexible---Weak strong
Direct personal contact with student
Tests interactive skills
Tests all levels : cognitive, psychomotor, affective

17. Merits Analytical skills and judgment
Samples a wide range of knowledge
Effective communication skills
Fast thinking and clear expression
Borderline cases
To award distinctintions

18. Merits Opportunity to defend statement if required
Understanding of subject – thoroughly tested
Less scope of cheating by the examinee
Individual and group problems in teaching and learning can be identified
Valuable immediate feedback for students, teachers and educational process

19. DEMERITS

20. Demerits – Extraneous Factors
Very subjective
Luck factor
Bias and impressions : “The halo effect "gender, accent, outward appearance, confidence
Impatient Examiner : Stressed examinee
Examiner sympathy : number of failures
Lack of interest / other preoccupation of the examiner
Unnecessary negative feedback

21. Demerits Lacks standardization Lacks objectivity and reliability
Lacks structure and organization
Subjective
Language barrier
Undue advantage of fluency and style
Disproportionate time and resources are spent

22. Demerits — Few trained examiners available — Novelty :
  — form of oral assessment being used may be unfamiliar to
the student
— Articulateness Vs knowledge :
  —Examiners can mistake a student’s articulateness for knowledge
12/04/2012

23. Examiners in viva Most examiners use this to only test recall
Only reel off facts… no attempt to test problem solving ability
Rarely any attempt to find out depth of knowledge
Duration of viva is generally too short

24. For the student ?? Importance of viva voce
Convey the fullest extent of understanding to the examiner
Behave normally … do not try to impress
Be composed … no medicines please !!

25. For the student Do not repeat questions
Say no… instead of beating around the bush or trying to bluff !
Avoid vagueness
Enter and leave graciously… both first and last impression are important

26. Purpose
Preclinical To cover areas not tested in practical examination or for testing additional knowledge Para-clinical To test additional skills like identifying slides, spots and specimens Clinical Emphasis is on X-rays, ECGs, identification of instruments and specimens

27. Common beliefs about viva
Marks obtained depend on whether candidate is examined at the beginning or end of session.
Fluency fetches more marks
Female candidates favored
Last candidates are favored
Some tables are “toxic”

28. Some facts about viva Lack of reliability
Inter-examiner reliability very low
Distinction marking trends seen:
By examiner
Examining team
By hour
By day
General tendency towards leniency
Errors of contrast : marks depend upon who gave viva before you

29. Some facts about viva
Marks awarded by examiner correlated positively and significantly with
Number of words used by student
Speaking time of the student during the exam
Marks awarded correlated negatively and significantly with
Number of words used by examiner
Percentage of time used by examiner
No significant correlation with same student’s marks in an objective test on same content material ( Evans et al )

30. Viva – some facts LACK OF OBJECTIVITY Arbitrary marking
Irrelevant and trivial questions asked
Lack of clarity in questioning
Variable level of difficulty of questions
No guidelines given to examiner
No agreement between examiners as to what is the correct answer : for that model answer should be structured
Error of logic : Examiner is not up to date with advances
Examiner expects an answer which he thinks is correct – unwilling to listen to any alternative

31. Conduct of examinations
Meeting of examiners to be called in advance… tell them
Stick to time schedule
Proceed from easy to difficult questions
Test all levels of knowledge in all domains
Maintain proper sequence of questioning and deviate when necessary
Graded questions on colored cards
Mark independently

32. Conduct of examinations
Make students comfortable, relieve them of anxiety
Appoint sufficient number of examiners
At least two examiners to examine candidate simultaneously
Many short sessions preferable to one long session
Plan to start a new topic every minute ( At least six topics in a half hour oral )

33. Techniques during viva
Spend a few moments putting a candidate at ease
Introduce each topic and define its area.
Go to the core of the question quickly using short questions and avoiding detailed scenarios
Avoid factual questions and unmarkable questions
If you plan to use props( letter, pictures, ECGs ) make sure that their function is clear and that they enhance the testing process and do not waste time

34. Techniques during viva
Plan tactics for difficult candidates – slow candidates, garrulous candidate
Poor candidate may need to be encouraged
Use non verbal encouragement
The more topics covered in an oral examination the better
When the bell goes, let the candidate finish his or her sentence before closing the examination

35. Higher order questioning
OPEN QUESTIONING
Can elicit many possible answers from candidate
Can evaluate better/ extract more information
Close question: what is normal blood sugar level ?
Open question : What is importance of knowing a patients blood sugar ?

36. Probing questions
Useful to elicit precise answers from a candidate when tentative or vague in his answers
May be of closed or open type and depend on the answer to the earlier query.
Initial Q : In this respiratory case, what test would you get done ?
Answer : Lung function tests, madam---
Probing Q : Tell me, what specific tests do you need in this case ?

37. Hypothetical Question
An open question relating to a hypothetical situation
Used for oral simulations, or to test the problem solving ability
What would you do if (describe the hypothetical situation)
Shall we now do a role play ? Assume that a am obese type 2 diabetic and you are my doctor. Give me diet and general advice

38. Challenge Question
An open question that challenges the candidate to provide further proof or details to justify his / her answer
In this case, what are the odd points which do not fit in?
If I ask you to argue against what you have just now said, what would you say ?
Explain the minimum criteria you need to justify your diagnosis.

39. Interactive style of questioning
Uses all types described above but after the initial query, subsequent questions are based on the candidate’s replies.
This interactive style is friendly, probing and test the depth of knowledge of the candidate.
Experienced examiners adopt this style to good effect.

40. Improving oral examinations
Improving validity, reliability and objectivity
OBJECTIVE STRUCTURED APPROACH
Requires advance planning
Prepare lists of tasks and ability to be tested by oral examination
According to core curriculum and additional areas
Cognitive, affective and communication areas
Prepare concrete examples
Formulate questions
Reach an agreement-- ?? Constitutes a correct answer

41. Structured viva Question should be : Clear Short Precise Unequivocal
Questions should
Cover all subtasks
In proper sequence
Test all levels of knowledge in different domains
Give standard set of questions to all examiners
Prepare standard marking system

42. Structured viva Other aspects : Fluency, confidence, expressive power
Prepare rating scale with agreed examples and agreed criteria of correct answers, perhaps, with a classification in to
Inadequate
Adequate
Satisfactory
After viva, take feedback from peers, students, teachers, colleagues, superiors- critically evaluate performance
Recycle viva voce project by planning, replanning and revaluation.