What's wrong with the traditional viva as a method of assessment in orthodontic education?

The oral or viva voce (viva) examination has been a mainstay of assessment throughout the history of medical education and widely used as a component of both undergraduate and postgraduate university examinations and professional examinations conducted by the medical and surgical Royal Colleges in the United Kingdom. This form of assessment has traditionally been chosen for its flexibility and potential for the testing of clinical and academic skills, both of which are closely associated with medical practice. However, in more recent years, the viva has fallen out of favour, leading to a reduction in use as a method of assessment, particularly for examinations conducted by the Royal Colleges. This trend has been seen within orthodontics, with the introduction of structured clinical reasoning and objective structured clinical examinations to replace oral and direct clinical examination in membership examinations. This article examines the reasoning behind why the traditional viva is regarded as being unreliable, describes some methods that are available to improve it and discusses recent developments in assessment within the context of oral examination, orthodontic education and training.