The viva voce innovation and experience at a new medical school in Rwanda

Abstract Background Traditional preclinical viva voce examinations have faced significant criticism due to inherent biases in their format. We developed a novel format and evaluated students’ views and experiences with it. Methods This study consists of two parts. Part 1 describes the development, i...

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Main Authors: Charles Okot Odongo, Samuel Ntaganira, Nicole Kanyana, Jean Paul Ndayizeye, Arlene Nishimwe, Jean Baptiste Niyibizi, Deogratias Ruhangaza, Abebe Moges Muche, Derbew Fikadu Berhe, Patrick Orikiriza, Daniel Seifu, Abebe Bekele
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Education
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Online Access:https://doi.org/10.1186/s12909-025-07463-6
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author Charles Okot Odongo
Samuel Ntaganira
Nicole Kanyana
Jean Paul Ndayizeye
Arlene Nishimwe
Jean Baptiste Niyibizi
Deogratias Ruhangaza
Abebe Moges Muche
Derbew Fikadu Berhe
Patrick Orikiriza
Daniel Seifu
Abebe Bekele
author_facet Charles Okot Odongo
Samuel Ntaganira
Nicole Kanyana
Jean Paul Ndayizeye
Arlene Nishimwe
Jean Baptiste Niyibizi
Deogratias Ruhangaza
Abebe Moges Muche
Derbew Fikadu Berhe
Patrick Orikiriza
Daniel Seifu
Abebe Bekele
author_sort Charles Okot Odongo
collection DOAJ
description Abstract Background Traditional preclinical viva voce examinations have faced significant criticism due to inherent biases in their format. We developed a novel format and evaluated students’ views and experiences with it. Methods This study consists of two parts. Part 1 describes the development, implementation and refinement of the preclinical viva voce examination at the University of Global Health Equity, in Rwanda, conducted over a four-year period. Part 2 describes students’ perspectives obtained through a self-administered online questionnaire. Results Part 1: The viva format features structured questions related to authentic clinical scenarios, that underscore the relevance of basic science knowledge to clinical practice. The examination consists of three oral stations plus one image-based station, which targets subjects that are traditionally difficult to examine like embryology, histology, and histopathology. The examination is vertically and horizontally integrated and provides students with multiple opportunities to demonstrate their knowledge. With four or more rotations of this kind, students are simultaneously examined, improving time efficiency, and reducing performance fatigue normally associated with long waiting times. Real-time scoring and commenting on individual student performances on shared files ensure examiner transparency and accountability, reducing bias. The examination ends with a faculty debrief conference, after which students receive individual feedback on their performance. Challenges encountered include examiner preferences for cases and the need for a substantial number of faculty to concurrently manage the numerous viva stations. Part 2: Students reported finding the viva format stressful but acknowledged its long-term benefits, including ability to foster mental agility, promote clinical reasoning, and improve their verbal communication skills. Compared to MCQ assessments, many students felt it was a better way of assessing knowledge, as it eliminated guesswork. Group discussions were identified as the most effective viva preparation strategy. Many students expressed a desire for more supportive interactions from examiners during the viva. Despite these challenges, there was broad agreement that the viva format should be retained. Conclusion The novel preclinical viva format described here enhances the reliability and validity of assessment while providing formative support and early clinical integration. It represents a balanced approach to addressing traditional viva limitations while maintaining educational value.
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spelling doaj-art-613e30a7c0de4a17acbf4e491aa50f8f2025-08-20T03:45:32ZengBMCBMC Medical Education1472-69202025-07-0125111110.1186/s12909-025-07463-6The viva voce innovation and experience at a new medical school in RwandaCharles Okot Odongo0Samuel Ntaganira1Nicole Kanyana2Jean Paul Ndayizeye3Arlene Nishimwe4Jean Baptiste Niyibizi5Deogratias Ruhangaza6Abebe Moges Muche7Derbew Fikadu Berhe8Patrick Orikiriza9Daniel Seifu10Abebe Bekele11University of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityUniversity of Global Health EquityAbstract Background Traditional preclinical viva voce examinations have faced significant criticism due to inherent biases in their format. We developed a novel format and evaluated students’ views and experiences with it. Methods This study consists of two parts. Part 1 describes the development, implementation and refinement of the preclinical viva voce examination at the University of Global Health Equity, in Rwanda, conducted over a four-year period. Part 2 describes students’ perspectives obtained through a self-administered online questionnaire. Results Part 1: The viva format features structured questions related to authentic clinical scenarios, that underscore the relevance of basic science knowledge to clinical practice. The examination consists of three oral stations plus one image-based station, which targets subjects that are traditionally difficult to examine like embryology, histology, and histopathology. The examination is vertically and horizontally integrated and provides students with multiple opportunities to demonstrate their knowledge. With four or more rotations of this kind, students are simultaneously examined, improving time efficiency, and reducing performance fatigue normally associated with long waiting times. Real-time scoring and commenting on individual student performances on shared files ensure examiner transparency and accountability, reducing bias. The examination ends with a faculty debrief conference, after which students receive individual feedback on their performance. Challenges encountered include examiner preferences for cases and the need for a substantial number of faculty to concurrently manage the numerous viva stations. Part 2: Students reported finding the viva format stressful but acknowledged its long-term benefits, including ability to foster mental agility, promote clinical reasoning, and improve their verbal communication skills. Compared to MCQ assessments, many students felt it was a better way of assessing knowledge, as it eliminated guesswork. Group discussions were identified as the most effective viva preparation strategy. Many students expressed a desire for more supportive interactions from examiners during the viva. Despite these challenges, there was broad agreement that the viva format should be retained. Conclusion The novel preclinical viva format described here enhances the reliability and validity of assessment while providing formative support and early clinical integration. It represents a balanced approach to addressing traditional viva limitations while maintaining educational value.https://doi.org/10.1186/s12909-025-07463-6Viva VocePreclinicalAssessmentRwandaUniversity of Global Health Equity
spellingShingle Charles Okot Odongo
Samuel Ntaganira
Nicole Kanyana
Jean Paul Ndayizeye
Arlene Nishimwe
Jean Baptiste Niyibizi
Deogratias Ruhangaza
Abebe Moges Muche
Derbew Fikadu Berhe
Patrick Orikiriza
Daniel Seifu
Abebe Bekele
The viva voce innovation and experience at a new medical school in Rwanda
BMC Medical Education
Viva Voce
Preclinical
Assessment
Rwanda
University of Global Health Equity
title The viva voce innovation and experience at a new medical school in Rwanda
title_full The viva voce innovation and experience at a new medical school in Rwanda
title_fullStr The viva voce innovation and experience at a new medical school in Rwanda
title_full_unstemmed The viva voce innovation and experience at a new medical school in Rwanda
title_short The viva voce innovation and experience at a new medical school in Rwanda
title_sort viva voce innovation and experience at a new medical school in rwanda
topic Viva Voce
Preclinical
Assessment
Rwanda
University of Global Health Equity
url https://doi.org/10.1186/s12909-025-07463-6
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