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Case based training systems are well accepted in medical education [1]. The

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The new media such as the internet and digital imaging offer new opportunities in medical education. In addition to conventional lectures, we developed a case-based simulation training program of 17 hematology cases using the novel training system d3web.Train. We evaluated the assessment of this internet course by medical students, as well as their results in the hematology exam. From a group of 150 students, 47 worked through at least one case and solved 435 cases in total; in average, these students solved 9.5 cases. Eighteen different students filled in a questionnaire about the training system and 68 questionnaires about individual cases. The main results were the students found the cases very helpful (1.5+/-0.6 on a scale from 1=very helpful to 5=not at all), the training system very good (1.4+/-0.5 on a scale from 1 to 6), and want to work with it further (1.2+/-0.4 on a scale from 1 to 5). During the final examination, those 16 students who answered that they had solved more than 5 from the 17 cases scored significantly better (two-sided t test, p<0.01) in the hematological part of the exam than those 34 students solving 0 to 5 cases. To our knowledge, this is the first student evaluation of a case-based training program in general hematology. The d3web.Train system offers a new and great tool for creating a training program in a reasonable amount of time, because it is able to process available patient records.

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Assessment drives learning. Examinations need to be aligned primarily with learning objectives, as well as teaching and assessment methods of the courses on offer. In doing so, various examination instruments are required to measure on levels of competency that build on one another. An appropriate mix is essential to reflect the variety of learning outcomes of a chosen curriculum. Furthermore, examinations also possess the characteristics of evaluation: They reflect the knowledge and abilities of students and assess the teaching at a defined location. Digital examinations in the form of multiple-choice-question (MCQ) testing enable a higher degree of automation and accelerate the processes of creation, implementation, and evaluation of the examination results. Thus, they enjoy increasing popularity, provided that the technical requirements for large semester cohorts are met. Shifting examination processes to computers or tablets entails not only a wealth of new challenges but also opportunities.

Testing based on multiple choice questions (MCQ) is one of the most established forms of assessment, not only in the medical field. Extended matching questions (EMQ) represent a specific type of MCQ designed to require higher levels of cognition, such as problem-solving. The purpose of this evaluation was to assess the suitability and efficiency of EMQ as an assessment method. EMQ were incorporated into the end-of-semester examination in internal medicine, in which 154 students participated, and compared with three established MCQ types. Item and examination quality were investigated, as well as readability and processing time. EMQ were slightly more difficult to score; however, both item discrimination and discrimination index were higher when compared to other item types. EMQ were found to be significantly longer and required more processing time, but readability was improved. Students judged EMQ as clearly challenging, but attributed significantly higher clinical relevance when compared to established MCQ formats. Using the Spearman-Brown prediction, only ten EMQ items would be needed to reproduce the Cronbach’s alpha value of 0.75 attained for the overall examination. EMQ proved to be both efficient and suitable when assessing medical students, demonstrating powerful characteristics of reliability. Their expanded use in favor of common MCQ could save examination time without losing out on statistical quality.

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