Feasibility Study of Self-Directed Mock Oral Examinations in the Assessment of General Surgery Resident Clinical Decision-Making

Authors

DOI:

https://doi.org/10.5195/ijms.2026.3978

Keywords:

General Surgery Residency, Education, Medical, Graduate, Educational Measurement, Board Examination Scores, Clinical Competence

Abstract

Background: This feasibility study describes the implementation of a self-directed mock oral examination (SD-MOE), which is administered in the absence of faculty examiners, and explores its potential as a supplemental tool in preparation for the American Board of Surgery Certifying Examination.

Methods: During a multi-institutional MOE, all examinees completed the conventional MOE (C-MOE) and were presented the option to additionally participate in the SD-MOE. Rates of technical issues were compared between formats. Exploratory analyses evaluated participant satisfaction, resource intensity, exam performance metrics, and interrater reliability.

Results: The C-MOE included 62 faculty examiners and 55 examinees, while the SD-MOE included 25 faculty examiners and 41 examinees. The frequency of technical issues did not differ between formats. Faculty examiner satisfaction was lower with the SD-MOE compared with the C-MOE (65% vs. 93%, P<0.01). Post-graduate year (PGY)-level correlated with mean case score (PGY-3: 2.45; PGY-4: 2.58; PGY-5: 2.70; P=0.01) and proportion of questions passed (PGY-3: 81.7%; PGY-4: 87.3%; PGY-5: 90.1%; P<0.01) in the C-MOE, but not the SD-MOE. PGY-level did not correlate with overall exam pass rates in either exam format. Interrater reliability estimates for the SD-MOE (weighted =0.32, 95% CI [0.19, 0.46]) and C-MOE (weighted k=0.25, 95% CI [0.16, 0.35]) had overlapping confidence intervals.

Conclusion: The SD-MOE was successfully administered with minimal logistical challenges. While limited by optional SD-MOE participation and differences in case counts between formats, this feasibility study suggests the SD-MOE can be considered as a supplemental tool for resource-limited institutions.

Author Biographies

Terrance Peng, MD, MPH. University of California Los Angeles David Geffen School of Medicine, Department of Surgery, Los Angeles, California, USA.

Resident-Physician
Department of Surgery

Ivy A. Huang, MD. University of California Los Angeles David Geffen School of Medicine, Department of Surgery, Los Angeles, California, USA

Resident-Physician
Department of Surgery

Marilee Fisher, BSN, BA (Fourth-year medical student). University of California Los Angeles David Geffen School of Medicine, Department of Surgery, Los Angeles, California, USA.

Medical Student
David Geffen School of Medicine

James X. Wu, MD. University of California Los Angeles David Geffen School of Medicine, Department of Surgery, Los Angeles, California, USA.

Assistant Professor of Surgery
Department of Surgery

Justin P. Wagner, MD. University of California Los Angeles David Geffen School of Medicine, Department of Surgery, Los Angeles, California, USA.

Assistant Professor of Surgery
Department of Surgery

Areti Tillou, MD, MEd. University of California Los Angeles David Geffen School of Medicine, Department of Surgery, Los Angeles, California, USA.

Professor of Surgery
Vice Chair for Education
Department of Surgery

Formosa Chen, MD, MPH. University of California Los Angeles David Geffen School of Medicine, Department of Surgery, Los Angeles, California, USA.

Associate Professor of Surgery
UCLA Health, Department of Surgery

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Published

2026-06-28 — Updated on 2026-10-27

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How to Cite

Peng, T., Huang, I. A., Nguyen, M., Fisher, M., Wu, J. X., Wagner, J. P., … Chen, F. (2026). Feasibility Study of Self-Directed Mock Oral Examinations in the Assessment of General Surgery Resident Clinical Decision-Making. International Journal of Medical Students, 14(2), 82–94. https://doi.org/10.5195/ijms.2026.3978 (Original work published June 28, 2026)

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Vol. 14 No. 2 (2026)

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Original Article

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Copyright (c) 2026 Terrance Peng, Ivy A. Huang, Marilee Fisher, James X. Wu, Justin P. Wagner, Areti Tillou, Formosa Chen

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