Interventional Radiology Board Examination Experience in Saudi Arabia during COVID-19.

Editor:

The COVID-19 pandemic has affected medical education considerably. To maintain social distancing, virtual meetings and conferences replaced in-person teaching. It became apparent that in-person examinations needed to be canceled, postponed, or conducted virtually. In Saudi Arabia, the Interventional Radiology (IR) fellowship is a 2-year program. Trainees take the oral and written certifying examination at the end of the fellowship. With the ongoing pandemic, the Saudi Commission for Health Specialties (SCFHS) along with the IR Board transitioned the examination to a virtual platform to allow the candidates to graduate while maintaining the essential component of the examination.

The number of examiners was reduced from 8 to 4. The testing was conducted on topics including; (a) vascular diseases, (b) nonvascular interventions, (c) interventional oncology, and (d) embolization. In addition, the examination was shortened from 16 cases in 120 minutes to 8 cases in 60 minutes. Each case had 3 competencies; approach, management, and safety. One point was given to each fulfilled competency. The passing score was set to 16 out of 24. Seven eligible candidates were tested from their homes. Zoom was used as the examination platform. A preliminary mock link was sent a week in advance to familiarize the examiners and candidates.

The examinations were monitored by the SCFHS, who were responsible for confirming the candidate’s identity, performing a 360 degrees room check, and recording the entire examination. The candidate remained in front of the camera during the entire examination and cell phone use was prohibited.

To obtain feedback and assess candidates’ satisfaction, a questionnaire was sent to all the candidates using Google Forms. Their response was recorded using a 5-point Likert scale (Strongly agree, agree, neutral, disagree, and strongly disagree). All candidates responded to the 11 questions detailed in the Table .

Table

Candidate Response to the Examination Questionnaire

Question	Score
The overall virtual examination experience was good	57.1% (4) agree28.6% (2) strongly agree14.3% (1) neutral
The time allotted was sufficient	57.1% (4) agree42.9% (3) strongly agree
The examination contents covered what I have learned	42.9% (3) strongly agree28.6% (2) agree28.6% (2) neutral
The questions format was clear	57.1% (4) strongly agree42.9% (3) agree
The examination interface was easy to navigate	42.9% (3) agree28.6% (2) strongly agree14.3% (1) neutral14.3% (1) disagree
The examination instructions were clear	57.1% (4) agree42.9% (3) strongly agree
The examination support team was helpful	57.1% (4) strongly agree28.6% (2) agree14.3% (1) neutral
I did not experience any technical difficulty during the examination	28.6% (2) strongly agree28.6% (2) agree28.6% (2) disagree14.3% (1) strongly disagree
I prefer the online format over the conventional one for future examinations	57.1% (4) neutral14.3% (1) agree14.3% (1) disagree14.3% (1) strongly disagree
My anxiety level was under control during the examination	57.1% (4) disagree28.6% (2) agree14.3% (1) neutral
The examiners were fair	85.7% (6) strongly agree14.3% (1) agree

Although this was a de novo experience for the Saudi Arabian IR Board, more than 70% of candidates agreed or strongly agreed that their overall experience was good. In addition, they responded positively to 8 out of 11 questions. The majority were satisfied with the allotted time, and the inclusiveness and fairness of the examination questions and examiners. However, about half of them had technical difficulties, and the majority were anxious during the examination and do not prefer the online format for future examinations.

Experience with virtual platforms has grown in the last year to cope with the COVID-19 pandemic in compliance with social distancing. Few mock virtual examinations were conducted by other specialties when the Saudi Arabian IR Board decided to go virtual in May 2020. While pilot examinations could be helpful to compare the virtual examination with the in-person one, no pilot examination was conducted due to time constraints. Despite the benefit of the virtual examination, the candidates prefer the in-person experience, which is contrary to the findings reported by Chaurasia et al (1).

As shown in our limited experience, the study illustrates that the virtual examination can serve as an alternative to the in-person one when needed. However, it might be preferable to keep the in-person examination as a default and use the virtual examination when the former is unavailable.