Pros and Cons
Without a doubt, going virtual enabled the board to avoid the public health risks associated with bringing in people from all over the country and gathering them together in one central location. But there were other benefits. With the virtual method, examinees enjoyed the convenience of not having to travel. “This exam takes place during fellowship for many candidates, while others are working to build their practices, and it can be difficult to take time off even for a weekend exam,” noted Dr. Holcomb. Also key was the fact that candidates saved on travel-related costs such as flights, vehicle rentals, accommodations, and other expenses.
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August 2021
Of the 14 [ABMS] boards that offer oral examinations, about one-third are committed to continuing with remote exams, one-third are leaning toward returning to in-person exams, and one-third are still considering the options. —Greg Ogrinc, MD, MS
Still, as Dr. Nussenbaum acknowledged, examiners did express disappointment over the missed opportunity to gather in person. “This in-person experience for examiners results in a remarkable sense of camaraderie, and that wasn’t there because everybody was in their own places at their computer and interacting only with their exam team members,” he said.
Meeting the technological requirements of the new format is another unavoidable challenge. “To take the exam virtually, [participants] have to make sure that their computer/hardware, software, webcam, and microphone are working properly; that they have access to high-speed internet; and that if they don’t have an ethernet cable, that their Wi-Fi is adequate and reliable,” explained Dr. Nussenbaum. “If an examiner has an IT problem, any of the others on the exam time can continue the exam and deliver the protocols. But if a candidate has a technology problem during the exam, it could lead to the need to reschedule to a future exam date.”
The idea of rescheduling the board exam is a worrisome prospect for any board certification candidate. “The oral board exam is only offered once a year, so having to reschedule due to technological issues can have severe consequences for employment, licensing, and credentialing,” pointed out Dr. Fox.
Given these potential consequences, administrators went the extra mile to ensure a smooth process technologically, taking pains to educate candidates and examiners, test equipment and connections, and answer any questions in advance. Board staff provided multiple individual check-ins with every exam candidate, including right before exam time. “The board provided several training sessions as well as a post-exam debriefing, which was quite helpful from a community standpoint,” Dr. Holcomb said.
The technological demands of the process might even have provided a friendly nudge toward a more environmentally friendly exam administration protocol, reflected Dr. Nussenbaum. “If you look at it from a green standpoint, it’s a lot of people not using planes and cars to get to the exam,” he said. “Also, previously, the exam materials, scoring, and evaluation forms were all on paper. When we changed to virtual, we also changed from a nearly completely paper exam to a fully electronic format.”
The electronic delivery has been so successful and well-received, in fact, that ABO-HNS intends to continue using a paperless exam even if in-person exams resume at some point. “It would work in an in-person environment, as long as you have a laptop with you,” said Dr. Nussenbaum.