*7.2.1 Open book examination*

Due to inadequate capacity to organize in-person examinations with social distancing protocols, open book examination (OBE) emerged as an assessment tool in medical education during the pandemic. First successful model of distant online assessment was pioneered by Imperial college of London [53]. Medical students were given 150 scenario based questions with findings from history and examination in which they had to answer regarding diagnosis and management. Randomizing the question order for each student was used as an effective tool to safeguard against cheating. Exposing them to time pressure (approximately 60 seconds per question), minimized chances to search intensively for the answer [54]. OBEs in contrast to conventional examination discourage rote and knowledge recall during assessments. These exams closely mimic actual clinical practice where such information can easily be retrieved from available resources in hospital. OBEs have therefore emerged as a practical assessment modality during the pandemic. As assessment drives learning, this kind of assessment will allow students to study in


#### **Figure 2.**

*Transformation of learning strategies in medical education during COVID-19 pandemic [49].*

#### *Unveiling the Uncertainty-Revolutionizing Medical Education in COVID-19 Era DOI: http://dx.doi.org/10.5772/intechopen.103918*

a way more aligned to real life clinical practice. Written OBE will allow more analytical thinking, evidence based practice and application of knowledge using multiple resources promoting students to be self-directed learners. This type of assessment also minimized anxiety among medical students taking exam while sitting in a home environment [55, 56].
