Background During the last few decades there has been a significant shift of teaching methods in higher education, from focusing upon facts towards a focus on problem solving and a deeper understanding of principles. Examination methods have not been developed correspondingly, which sends contradictive signals to students and is devastating for learning outcomes. Even if there are some examples of interesting and IT-based examination methods, there is a need for research on how to practically implement these new methods in various disciplines and also on how to solve common problems with newer examination tools, e.g. security, integrity, validity & IT-support. In medicine, Web-based cases have been used successfully for learning. These simulated cases might be more efficient and standardized than other case-based methodologies in that every interaction might be logged and followed, the use and interpretation of different physical examination and laboratory tests might be assessed etc. It has therefore been suggested to use the Web-SP case system for examination and self-assessment in medicine. In a pilot study, Web-SP has shown good potential as an examination tool also for teacher education.   The overall aim of this project is to study three interlinked research questions: Is it possible to adapt Web-SP for examination purposes, including solving issues of security, integrity and scoring? Might this examination system be useful for case-based exams in medicine? Is Web-SP flexible enough to be used as an assessment tool also in a completely new discipline as teacher education? The project targets two main disciplines – medicine and teacher education at Stanford, Umeå university and Karolinska Institutet. Thus, three universities and four educational programs are targeted. The Web-SP system and its pedagogical idea have been very successful in terms of a huge international interest. This wide base of Web-SP implementations in a vast number of disciplines, courses and curricula is a good foundation for a sustainable use of Web-SP for examination purposes. Moreover, the international interest for newer form of examination methods is rapidly growing, which indicates that if successful, this project will have a very good sustainability potential.