Modern information and communication technologies are common, sometimes even essential complement of education at universities. Using these tools in the knowledge evaluation process is perceived by various institutions differently. Learning approaches and methodologies offer a variety of perspectives on this issue. Many learning management system are used for electronic examination across the MEFANET (MEdical FAculties NETwork). This contribution focuses on theoretical background, which is crucial for preparation of the high quality evaluation materials. The design concept of evaluation, building methods of various test questions and analysis methods are discussed in detail. Risk areas and the most common pitfalls in the use of electronic examination testing, as well as the benefi t of all stakeholders (students, teachers, educational institutions, clinical practice, etc.) are further mentioned. Finally, questions related to the classifi cation of tests within each part of the educational process are discussed. Accented are requirements for different purposes of using the electronic testing agenda (assessment of knowledge, ability of critical thinking, independent work in Problem Based Learning, etc.).