Comparative analysis reveals how exam formats affect assessment reliability and academic integrity in medical education.
Examination modality strongly impacted on performance and reliability. Unproctored online exams led to grade inflation, reduced variability, and low reliability, while proctored formats-physical or virtual-reinstated assessment rigor, fairness, and psychometric integrity, emphasizing the need for robust invigilation in high-stakes medical assessments.
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Krishnamurthy et al. (2026) studied this question.
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