Assessment strategies play a pivotal role in influencing how medical students learn, organize information, and develop clinical reasoning abilities. With the introduction of Competency- Based Medical Education (CBME) in India, there has been a paradigm shift from traditional rote-based examinations toward assessment formats that emphasize conceptual understanding and application of knowledge in clinical contexts. This shift aligns with global recommendations advocating for structured, transparent, and competency-driven evaluations in medical training ¹ To support this transition, the Rajiv Gandhi University of Health Sciences (RGUHS) recently revised the Biochemistry examination pattern for first-year MBBS students. The new structure includes a long essay, reasoning-based short answers, applied short notes, and scenario-based MCQs—formats intended to assess higher-order cognitive skills as outlined in CBME guidelines

2. ². Such tools are known to strengthen analytical thinking, clinical correlation, and decision- making—competencies essential for the Indian Medical Graduate ³.

Previous studies have highlighted the need for valid, blueprint-based assessments and standardized student feedback mechanisms to improve teaching–learning processes ⁴. However, most published literature examines CBME implementation broadly, with limited research focusing specifically on student perceptions of the revised RGUHS examination pattern, especially in foundational subjects like Biochemistry. Evidence addressing how first-year students adapt to reasoning-based and application-oriented questions remains sparse in the Indian MBBS context ⁵.

Therefore, this study was undertaken to address this gap by evaluating first-year MBBS students’ perceptions of the revised RGUHS Biochemistry examination pattern. The study aims to assess student understanding of the new blueprint, determine the perceived difficulty and effectiveness of its components, and generate evidence to guide faculty and policymakers in refining assessment strategies.

Materials and Methods

This descriptive, cross-sectional study was conducted among first-year MBBS students at S R Patil Medical College, Hospital & Research Center, Badagandi, Karnataka, India, following the completion of the Biochemistry examination conducted under the revised RGUHS assessment pattern. All first-year MBBS students who appeared for the examination were invited to participate, and a total of 99 students provided written informed consent and completed the study questionnaire. Participation was voluntary, and no incentives were offered.

A convenience sampling method was employed to recruit participants during scheduled academic hours. Students were included if they were enrolled in the first-year MBBS course, had appeared for the Biochemistry examination, and were willing to provide written informed consent. Students who were absent for the examination, unwilling to participate, or submitted incomplete questionnaires were excluded from the study.

Data were collected using a structured, pre-validated questionnaire developed according to established psychometric guidelines ⁶. The questionnaire comprised four sections. Section A captured demographic characteristics, Section B assessed awareness and understanding of the revised RGUHS exam pattern, Section C evaluated perceptions of each exam component using a five-point Likert scale ranging from strongly agree to strongly disagree, and Section D included open-ended questions to obtain qualitative reflections and suggestions. The questionnaire was pilot-tested prior to administration to ensure clarity and reliability.

The questionnaire was distributed to participants in classrooms after explaining the study objectives and obtaining informed consent. Participants completed the forms anonymously under the supervision of the research team to ensure completeness and accuracy.

Quantitative data were entered into Microsoft Excel and analyzed using descriptive statistics, including frequencies, percentages, means, and standard deviations. Qualitative responses from open-ended questions were analyzed using a thematic analysis approach to identify common ideas and perceptions among students.

Ethical approval was obtained from the Institutional Ethics Committee of S R Patil Medical College prior to the initiation of the study. Written informed consent was obtained from all participants. No personal identifiers were collected, and all data were kept confidential. The study posed no risk to participants and did not receive any external funding.

Table1 . Demographic Characteristics of the Participants (N = 99).

Table 2. Awareness of New Examination Pattern

Table 3. Perception of Long Essay Questions

Table 4. Perception of Reasoning Questions.

Table 5. Perception of Applied Questions

Table 6. Perception of Scenario-Based MCQs

Table 7. Exam Stress and Learning

Figure 1. Distribution of Student Perception towards Each Exam Component

Figure 2. Stress and Learning Adaptation Responses

DISCUSSION

The shift to CBME-based assessment is intended to promote deeper understanding and clinical application. Students in this study responded positively to the revised RGUHS exam pattern. Long essays and reasoning questions were particularly valued for enhancing conceptual clarity and clinical reasoning, aligning with findings from Sharma et al⁷. Applied questions and scenario-based MCQs were effective in integrating clinical contexts with theoretical knowledge. However, many students struggled with time management, similar to issues noted in earlier CBME-focused evaluations ⁸. Increased stress levels indicate the need for improved orientation and formative assessments to help students adapt to the new format.

Overall, the results support continued use of the revised pattern while suggesting refinements such as practice sessions and time-management training.

CONCLUSION

The revised RGUHS Biochemistry exam pattern was well received by first-year MBBS students. They perceived it as promoting conceptual clarity, clinical integration, and long-term retention. Despite increased stress and time constraints, students appreciated the shift away from rote memorization. Continuous orientation and structured formative assessments may enhance its effectiveness.

Limitations: Single-center study, Convenience sampling may limit generalize ability and Self-reported data may include subjective bias

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