Introduction: Assessment and evaluation are major parts of the medical curriculum which motivate students to study, being a competent physician, and achieving the medical education eligible goals. Medical students, especially at undergraduate levels, experience a significant amount of anxiety due to frequent exams. Meanwhile, the coronavirus disease 2019 disaster forced higher educational institutes all over the world to adopt distance learning. So remote online exams were used as a kind of assessment that can lead to new paradigms.Methods: This cross-sectional study was planned to assess the remote online exams anxiety during COVID-19 Pandemic by analyzing test anxiety categories among basic science and pre-clinical medical students and its correlation between genders in the School of Medicine, Mashhad University of Medical Sciences, Iran, in 2020. Data collection tools were Demographic Questionnaire and Sarasons’s Test Anxiety Scale. Descriptive statistics (mean, percentages) and analytical statistics (t-test and one-way ANOVA) were used to analyze the data with SPSS version 11.5.Results: 290 medical students in basic science and pre-clinical courses were enrolled. 194 (66.4%) of participants were female and 177 (60.6%) were in basic sciences course. The prevalence of mild, moderate, and severe anxiety was 27.9%, 36.9%, and 35.2% respectively. The difference in the mean and SD of anxiety score in basic sciences students and pre-clinical students was not statistically significant (Pvalue=0.26), yet the results indicated that the level of anxiety in females (19.07+7.11) is significantly higher than males (14.44+7.15) (Pvalue<0.001).Conclusion: According to the current study, there is a critical need to take steps to recommend stress management techniques and bring reforms in E-learning and E-assessment systems to lower the anxiety in medical students while providing a stable and reliable electronic exam environment can be helpful.

Background: The coronavirus disease 2019 (COVID-19) crisis has greatly impressed medical education by shifting traditional educational methods to e-learning. Objectives: This study evaluated the undergraduate medical students' attitudes toward e-learning during the COVID-19 pandemic Methods: This cross-sectional study included undergraduate medical students of Mashhad University of Medical Sciences, Mashhad, Iran, in the academic year 2020 - 21 by census sampling method, whose attitude toward e-learning was evaluated based on the Ghanizadeh et al. scale. Categorical variables were demonstrated with frequency and percentage, and quantitative variables were described using the mean and standard deviation. An independent-sample t test was run to study the hypothesis. Analysis of covariance (ANCOVA) was performed to compare pre-clinical and clinical groups' attitudes toward e-learning after gender control. Statistical analyses were performed by SPSS 23. Results: The study enrolled 528 undergraduate medical students. The findings indicated that 85.4% of the students agreed with the necessity of more effective e-learning in medical education, and 95.5% believed that e-learning should play a complementary role in medical education. It was found that clinical students had a marginally statistically significantly better attitude toward e-learning than pre-clinical students (t = -2.04, df = 526, P = 0.041). Nevertheless, no significant difference was observed between the two groups after gender control (t = 2.87, P = 0.091). It was shown that males had more positive attitudes toward e-learning than females (t = 2.28, df = 526, P = 0.023). Conclusions: The results revealed acceptable attitudes toward e-learning. Although many students declared e-learning's usefulness and confirmed its complementary role in medical education, some announced that it could not replace in-person training.

Introduction This study investigated medical students’ intended learning outcomes based on e-learning and in-person education. Methods In this cross-sectional comparative analytical study, a group of 126 undergraduate medical students’ intended learning outcomes under two different teaching methods, including e-learning and in-person, were repeatedly measured based on the census sampling method. Participants were in the preclinical curriculum phase (physiopathology) at Mashhad University of Medical Sciences (MUMS), Iran. Due to expert panel opinion, the same medical teachers and similar difficulty of lessons were considered in two investigated academic semesters. In addition, difficulty and discrimination indexes of formative and summative assessments were controlled for two study groups. The students’ learning outcome index was the knowledge test scores participants received in the relevant lessons of the General Medicine (GM) curriculum preclinical courses. Results The findings indicated that students learning outcomes were significantly higher during e-learning than in in-person education for all examined variables (P < 0.05). Moreover, the difference between students’ Grade Point Average (GPA) categories among the two groups was significant (P = 0.022). Students with a GPA of less than 14 experienced higher increments in their average scores after the e-learning compared to in-person education. Compared to face-to-face courses, improvements in pharmacology, theoretical semiology, and pathology scores after e-learning courses were statistically significant (P < 0.001). The differences in mean scores related to practical pathology and semiology in the two approaches were not statistically significant, P = 0.624 and P = 0.149, respectively. Furthermore, the overall students’ average scores increased significantly during e-learning versus in-person education (P < 0.001). Conclusion We concluded that e-learning could be appreciated as a successful method of medical education and can be used as an alternative educational method. However, considering the importance of practical or clinical courses in medical education, further research about the efficacy of the e-learning approach is highly recommended.

Introduction: Clinical education is the basic pillar and heart of medical education. In fact, it is one of the most important manifestations of teaching and learning in professions related to medical sciences, which leads to the clinical competency of learners. Assessing new physicians before entering the field of clinical activities can be a reliable criterion for evaluating the quality of their clinical skills.The current study was done to investigate the knowledge, practice, and general clinical competency of general medicine graduates before entering the field of clinical activities. The study was in line with according to the document of the minimum competency expected from general practitioners in Iran. Methods In this descriptive cross-sectional study, the scores of different stations of the national Objective Structured Clinical Examination (OSCE), which be held at the end of the general medicine course in Iran, were collected at Mashhad University of Medical Sciences. These scores were subdivided into four specific areas and two critical and non-critical indicators of capability were gathered from the exam assessors' checklists. Totally, 266 students who participated in six periodicities of clinical competency tests at the end of the general medicine course at Mashhad University of Medical Sciences were included in the study by the census method. The clinical competency of general medicine graduates assessed in the areas of problem-solving, communication skills, practical action (procedures and critical skills), taking the history, performing physical examinations, and critical and non-critical indicators by the OSCE. Data were analyzed using descriptive statistics (frequency, mean and standard deviation) and inferential statistics including independent t-test, one-way and two-way analysis of variance by using SPSS. Results The results showed that the effect of different areas of the OSCE (F(3,5652) = 7.022 and P = 0.001) and participants' performance based on their critical and non-critical indicators (T = 1.976 and P = 0.04) are significant with 95% confidence interval. Conclusion The OSCE improves the standards of clinical competencies of new physicians and can make beneficial changes in clinical education at medical schools.

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