Application of computer-based testing in the Korean Medical Licensing Examination, the emergence of the metaverse in medical education, journal metrics and statistics, and appreciation to reviewers and volunteers

On January 6–7, 2022, computer-based testing (CBT) was adopted for the Korean Medical Licensing Examination (KMLE) [1] (Fig. 1). This is the first instance of CBT adoption for any of the 26 health professional licensing examinations in Korea. Of course, smart device-based testing (SBT), a variant of CBT, was already adopted for the Korea Emergency Medicine Technician Licensing Examination in 2017 [2]. Examinees’ demographic characteristics and perceived acceptability of SBT did not affect the SBT mock test scores of emergency medicine technician students in Korea [3]. After implementing CBT in the KMLE, it will be expanded to all other 24 professions, including dentists, oriental medicine doctors, and care workers, by 2025 [1]. On March 21, 2003, presenters first proposed CBT and computerized adaptive testing (CAT) for the KMLE at a seminar held by the Institute of Medical Education of Hallym University at the Chuncheon Sejong Hotel. At that time, the staff members of the Korea Health Personnel Licensing Examination Institute (KHPLEI) attended the seminar. Thus, 19 years have passed since CBT and CAT were suggested for licensing examinations in Korea. In November 2011, the Standing Committee of the KMLE recommended introducing computerized testing to the KMLE, including CBT and CAT [4]. I also suggested improving the quality of the KMLE through the introduction of computerized testing and recommended that medical schools should prepare for the new testing environment of the KMLE [4]. The 6th president of the KHPLEI, Dr. Myung-Hyun Chung (August 1, 2012–July 31, 2015), announced that research and development on CBT and ubiquitous-based testing would be accelerated in January 2013 [5]. Research on CBT then became more active. For example, the linear programming method was suggested to construct equated-item sets that reflect each content area. The best choice was to divide the predicted correct answer rate into 2 or 3 difficulty boundaries regardless of common items [6]. Because SBT was already well implemented in the Korea Emergency Medicine Technician Licensing Examination [3], there was no need to repeat an evaluation of the examinees’ adaptability to CBT. The only step left was decision-making by the president of KHPLEI. Dr. Yoon-Seong Lee, the 8th president, finally decided to introduce CBT. CBT has already been a very common testing platform at most medical schools. For example, at Hallym University, CBT was introduced in 1999 for clinical course testing. In my parasitology class, CBT was already introduced in 1993. My students have had no difficulties in taking CBT. A new task after adopting CBT is to guarantee item quality, including that of audio-visual materials. CBT items should be more clinically oriented than paper-and-pencil materials to test examinees’ clinical competency. Application of computer-based testing in the Korean Medical Licensing Examination, the emergence of the metaverse in medical education, journal metrics and statistics, and appreciation to reviewers and volunteers