Digital assessment is becoming more and more popular within medical education. To analyse the dimensions of this digital trend, we investigated how exam questions (items) are created and designed for use in digital medical assessments in Germany. Thus, we want to explore whether different types of media are used for item creation and if a digital trend in medical assessment can be observed. In a cross-sectional descriptive study, we examined data of 30 German medical faculties stored within a common assessment platform. More precise, 23,008 exams which contained 847,137 items were analysed concerning the exam type (paper-, computer- or tablet-based) and their respective media content (picture, video and/or audio). Out of these, 5252 electronic exams with 12,214 questions were evaluated. The media types per individual question were quantified. The amount of computer- and tablet-based exams were rapidly increasing from 2012 until 2018. Computer- and tablet-based written exams showed with 45 and 66% a higher percentage of exams containing media in comparison to paper-based exams (33%). Analysis on the level of individual questions showed that 90.8% of questions had one single picture. The remaining questions contained either more than one picture (2.9%), video (2.7%), audio (0.2%) or 3.3% of questions had picture as well as video added. The main question types used for items with one picture are TypeA (54%) and Long_Menu (31%). In contrast, questions with video content contain only 11% TypeA questions, whereas Long_Menu is represented by 66%. Nearly all questions containing both picture and video are Long_Menu questions. It can be stated that digital assessment formats are indeed on the raise. Moreover, our data indicates that electronic assessments formats have easier options to embed media items and thus show a higher frequency of media addition. We even identified the usage of different media types in the same question and this innovative item design could be a useful feature for the creation of medical assessments. Moreover, the choice of media type seems to depend on the respective question type.

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数字化时代的医学评估

数字评估在医学教育中越来越受欢迎。为了分析这种数字趋势的规模，我们调查了如何创建和设计考试题（项目）并设计用于德国的数字医学评估。因此，我们想探讨是否使用不同类型的媒体进行项目创建，以及是否可以观察到医学评估中的数字趋势。在横断面描述性研究中，我们检查了存储在公共评估平台中的30个德国医学院的数据。更准确地说，分析了23,008项考试，其中包含847,137项，涉及考试类型（基于纸，计算机或平板电脑）及其各自的媒体内容（图片，视频和/或音频）。其中，对5252项电子考试进行了评估，评估了12214题。量化每个问题的媒体类型。从2012年到2018年，基于计算机和平板电脑的考试数量迅速增加。基于计算机和平板电脑的笔试与纸质考试（33％）相比，包含媒体的考试占45％和66％的比例更高。对单个问题水平的分析表明，有90.8％的问题只有一张照片。剩余的问题包含不止一张图片（2.9％），视频（2.7％），音频（0.2％）或3.3％的问题带有图片和视频。用于一张图片的项目的主要问题类型为TypeA（54％）和Long_Menu（31％）。相反，具有视频内容的问题仅包含11％的TypeA问题，而Long_Menu由66％代表。几乎所有同时包含图片和视频的问题都是Long_Menu问题。可以说，数字评估格式的确在增加。此外，我们的数据表明，电子评估格式具有嵌入媒体项的更简便选择，因此显示了更高的媒体添加频率。我们甚至在同一个问题中确定了不同媒体类型的用法，而这种创新的项目设计可能是创建医学评估的有用功能。此外，媒体类型的选择似乎取决于相应的问题类型。