Enhancing medical assessment strategies: A comparative study between structured, traditional and Hybrid viva-voce assessment.

Background: Medical students' skills and knowledge have traditionally been assessed through written and oral examinations (viva-voce). Structured viva-voce is an objective structured method to orally assess students. As an assessment tool it was used informally since 1989, however it was publicized by describing it separately by Oakley and Hencken in 2005. Hybrid method is combination of both structured and traditions viva-voce methods This study aims to assess the methods for inter-examiner consistency to minimize variations in scoring during viva-voce. It further investigates medical students' perceptions regarding the fairness, transparency, and overall experience of the assessment formats: structured viva-voce, traditional viva-voce, and hybrid method. By examining these perspectives, the study seeks to provide insights into optimizing viva-voce methods for improved reliability and student satisfaction. Methods: Oral assessment was scheduled. Validated structured viva-voce cards, based on Bloom’s taxonomy and expert-reviewed, were prepared. Each student underwent a 5-minute structured viva using two different card sets, followed by a 5-minute traditional viva conducted by both examiners. A hybrid format included combining both methods. Feedback was obtained through a mixed questionnaire with quantitative (Likert scale) and qualitative (open-ended) items on the examination methods. Results and conclusion: The study evaluated variation in scoring between 2 examiners for three viva-voce formats: structured, traditional, and hybrid (a combination of both traditional and structured) among 151 students with 53.6% females and 46.3% males. The Wilcoxon signed rank test revealed significant inter-examiner variability in structured viva-voce and Set 2 of traditional viva-voce (p < 0.05), while the hybrid method showed better consistency between examiners. Pearson correlation and reliability analyses indicated that the hybrid viva-voce demonstrated higher inter-examiner consistency, correlation coefficients, and reliability (ICC and Cronbach’s α = 0.663) compared to structured and traditional formats, suggesting it may be a more effective assessment method. Feedback revealed that 56% of students preferred the hybrid format for its balance of objectivity and flexibility. While structured viva-voces excelled in fairness and coverage, traditional viva-voces were appreciated for flexibility but suffered from inconsistency. Overall, the hybrid format emerged as the effective assessment method, offering enhanced reliability and student satisfaction by addressing the shortcomings of both individual formats. These findings suggest the potential of hybrid viva-voce in fostering a consistent and comprehensive evaluation framework.