Practical Assessment Of Clinical Examination Skills Research Articles

How to approach jaundice in the MRCP PACES exam.

For every medical trainee, the Membership of the Royal College of Physicians' Practical Assessment of Clinical Examination Skills (PACES) exam is one of the most difficult exams they must face in their career. It is designed to assess the clinical knowledge and skills of the trainee doctors who are entering higher specialist training. It sets rigorous standards to ensure the competence of the candidates across a range of skills. This article discusses a systematic approach to a patient with jaundice, which is a commonly encountered station in the exam, so that candidates will become more familiar with common causes and how to differentiate between these, as well as important bedside examination skills.

Can achievement at medical admission tests predict future performance in postgraduate clinical assessments? A UK-based national cohort study

ObjectiveTo determine whether scores on two undergraduate admissions tests (BioMedical Admissions Test (BMAT) and University Clinical Aptitude Test (UCAT)) predict performance on the postgraduate Membership of the Royal Colleges of...

How to Prepare for the Membership of the Royal College of Physicians (UK) Part 2 Clinical Examination (Practical Assessment of Clinical Examination Skills): An Exploratory Study

The Practical Assessment of Clinical Examination Skills (PACES) examination is considered the most difficult component of the three-part Membership of the Royal College of Physicians (MRCP) United Kingdom (UK) diploma, which provides budding physicians with access to a diverse pathway of subspecialties and a rewarding medical career. Preparing for the exam is onerous, especially when also juggling work and family demands. This research explored how candidates can prepare for this exam in an organised manner to improve their chances of first-pass success. Semi-structured interviews were conducted with 10 participants in the West Yorkshire region in the UK who had passed the PACES examination within 24 months. The interviews were transcribed onto QSR NVivo software, coded reflexively and analysed using thematic analysis. The analysis identified 25 codes that were aggregated into the following themes according to their density; (a) mental conditioning, (b) clinical exposure, (c) external factors and support, (d) revision courses, (e) knowledge acquisition, (f) playing the objective structured clinical examination (OSCE) game, (g) change of strategy, and (h) novel methods. In summary, it takes more than just clinical exposure and rote learning to pass the exam; preparation involves a complex, multifaceted approach. With proper mental conditioning, organisational skills and confidence, the adverse effect of test anxiety could be reduced to improve chances of success. Peer learning is an effective tool for facilitating examination preparation among candidates, besides providing a supportive framework. Cues from this study could act as a guiding framework for future PACES candidates to further refine their study strategies.

Passing MRCP (UK) PACES: a cross-sectional study examining the performance of doctors by sex and country

BackgroundThere is much discussion about the sex differences that exist in medical education. Research from the United Kingdom (UK) and United States has found female doctors earn less, and are less likely to be senior authors on academic papers, but female doctors are also less likely to be sanctioned, and have been found to perform better academically and clinically. It is also known that international medical graduates tend to perform more poorly academically compared to home-trained graduates in the UK, US, and Canada. It is uncertain whether the magnitude and direction of sex differences in doctors’ performance is variable by country. We explored the association between doctors’ sex and their performance at a large international high-stakes clinical examination: the Membership of the Royal Colleges of Physicians (UK) Practical Assessment of Clinical Examination Skills (PACES). We examined how sex differences varied by the country in which the doctor received their primary medical qualification, the country in which they took the PACES examination, and by the country in which they are registered to practise.MethodsSeven thousand six hundred seventy-one doctors attempted PACES between October 2010 and May 2013. We analysed sex differences in first time pass rates, controlling for ethnicity, in three groups: (i) UK medical graduates (N = 3574); (ii) non-UK medical graduates registered with the UK medical regulator, the General Medical Council (GMC), and thus likely to be working in the UK (N = 1067); and (iii) non-UK medical graduates without GMC registration and so legally unable to work or train in the UK (N = 2179).ResultsFemale doctors were statistically significantly more likely to pass at their first attempt in all three groups, with the greatest sex effect seen in non-UK medical graduates without GMC registration (OR = 1.99; 95% CI = 1.65-2.39; P < 0.0001) and the smallest in the UK graduates (OR = 1.18; 95% CI = 1.03-1.35; P = 0.02).ConclusionsAs found in a previous format of this examination and in other clinical examinations, female doctors outperformed male doctors. Further work is required to explore why sex differences were greater in non-UK graduates, especially those without GMC registration, and to consider how examination performance may relate to performance in practice.

The benefits of a peer-assisted mock PACES.

Peer-assisted learning (PAL) and mock examinations have been credited as effective teaching tools; however, there is a lack of research into their effectiveness in PACES (practical assessment of clinical examination skills). This study demonstrates an effective model and the benefits of PAL after its implementation in a mock PACES at Imperial College London. There is a lack of research into the effectiveness of PAL and mock examinations in PACES METHODS: A mock PACES was designed for fifth-year medical students. Examiners were recruited from the final year and from the foundation year doctor (intern) cohort. A Likert scale (1, strongly disagree; 5, strongly agree) questionnaire given before and after the exam was used to investigate its effectiveness. A total of 41 pre-mock exam surveys (57% completion rate) and 57 post-mock exam surveys (79% completion rate) were completed. Students felt significantly more confident after the mock PACES (mean 3.54 post-mock exam versus 2.68 pre-mock exam), with 90.64percent of students agreeing that this mock PACES was more useful than a lecture-based format, bedside teaching and small group teaching in order to prepare for this exam. Twenty-eight tutor surveys were completed (87.5% completion rate). Tutors agreed that the mock PACES had improved their confidence in their teaching ability (mean 4.07) and enhanced their clinical knowledge (mean 4.18). The mock PACES demonstrated benefits to confidence levels and knowledge both for tutees and tutors. The results demonstrate an effective model in examination preparation for PACES. This reinforces the holistic positive attributes gained from the use of PAL and mock examinations, whilst encouraging its use within the undergraduate syllabus.

Performance at MRCP(UK): when should trainees sit examinations?

This paper analyses candidate performance in the three components of the MRCP(UK) examination to establish when they are most likely to pass. Using data from the 2010 and 2011 MRCP(UK) examinations, pass rates of candidates who gained their primary medical qualification (PMQ) in 2005 or later were analysed. Results from a total of 22,827 candidates were included in the study: 12,517 (54.8%) from Part 1, 5,545 (24.3%) from Part 2 written and 4,765 (20.9%) from the Part 2 practical assessment of clinical examination skills (PACES). The results show that candidates are more likely to pass Part 1 and Part 2 written 12–24 months after graduation and to pass Part 2 PACES 25–36 months after graduation. When we consider the training programme for physicians in the UK, successful candidates are likely to be in foundation programmes or early core or specialty training when they achieve success. At the moment, some candidates are dissuaded from taking the examination during their foundation programme, but our data show that their likelihood of success is highest during this period of training. The analysis also shows that for candidates who fail their first attempt, delaying their next attempt by one diet significantly increases the likelihood of them passing at their next attempt.

Analysis of predictors of success in the MRCP (UK) PACES examination in candidates attending a revision course

Objective: To determine factors that predict success of candidates taking a revision course in preparation for the MRCP (UK) PACES (practical assessment of clinical examination skills) examination. Design: A questionnaire...