Written Evidence submitted by Academy of Medical Royal Colleges

 

Evidence for Education Select Committee

How exams and professional qualifications are being impacted during the pandemic

 

 

Active work on going between Colleges, GMC and SEBs under auspices of the Academy.

Need to maintain full GMC standards for exam content, delivery and certification.

Requirement to deal with backlog and time sensitive delivery of exams to meet progression and certification timelines and meet the derogation requirements set by the GMC to permit progression of training and a pipeline of qualified medical staff.

Exams test knowledge and higher order thinking in the application of knowledge to unfamiliar scenarios.

Timescale for changes needed:

Immediate (completed)

Cancellation from March to July and later
 

Short term

To permit delivery of exams in Summer / Autumn 2020

No change to format (majority) written and knowledge-based exams

Rapid GMC approval for format change to permit delivery

Medium / long term

To reduce reliance on clinical (patient) components within exams.

 

Factors limiting exams related to viral environment:

Lockdown and risk of re-lockdown

Limited social contact

Patient anxiety regarding attendance at healthcare facilities

Possibility for small, medium or large gatherings

Limiting 1-1 interactions to essential care

Venue availability

Clinical facility availability

Clinician examiner availability

Great stringency needed for medical gatherings

Travel limitations – to exam venues
 

 

Exam type delivery by degree of limitation due to viral environment:

Written / MCQ / computer delivered

None

Online open book at home

Online invigilated at home

Computer delivered test centre

Examination hall

Oral / viva

None

Online videoconference

In person

Clinical (OSCE/traditional)

None

Recorded videos of workplace based testing submitted for central assessment

Live online videos of workplace based testing assessed centrally in real time

In person with health volunteers

Centralised or distributed delivery

Distributed in person with patients

Centralised in person with patients

Nonclinical venue

In hospital.
 

Rate and degree of change needed:

Rapid rate and extensive change

Repeat lockdown this summer / autumn / winter

Moderate rate and moderate change

Socially distanced medium sized gatherings

Slow rate and limited change

Larger gatherings possible.
 

College approaches:

Planning for the worst and hoping for the best

Looking for opportunities to improve on existing processes

Actively sharing ideas for exam delivery

Common approaches to modification of exam design

Develop principles and consistency across specialties.
 

GMC approaches:

No preference for exam method

No approval required for some changes

Self-assessment for some changes

Streamlined group approval for similar changes

Streamlined individual approval for unique changes

Need assurances that candidates can demonstrate capabilities through assessment techniques.
 

 

Specific adaptations planned:

Similar format with increased numbers of sittings to permit social distancing

Movement of written exams from halls to online test centres

Online remote invigilation of written / MCQ exams

Use of videoconferencing for orals/vivas

Remote delivery of OSCE

Remote assessment of workplace delivered test using recorded or live video

Potential use of Nightingale (or equivalent) Hospitals for clinical exams, using additional space for social distancing

Dividing clinical exams into components which can be delivered by video conference (e.g. interpretation of investigations, communication) and those which need patient contact (history and examination)Deferring exams to later in 2021in specialties in which this will not impact progression.
 

Actions underway:

Developing an AoMRC central repository of proposed changes, timescales and risk to inform GMC plans for rapid approval processes

Meeting planned to discuss workplace delivered centrally assessed clinical exams.

 

June 2020

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