Clare Owen¹
Veronica Davids²
1 MSC
2 Medical Schools Council

Background
The Medical Schools Council (MSC) is working with UK medical schools to introduce a national applied knowledge test (AKT) that will form part of the Medical Licencing Assessment regulated by the General Medical Council (GMC). A governance system has been put in place to oversee the design and development of the assessment. 

Summary of work
Once the committee structure was in place the utilisation of the governance process was piloted in 2021/2022. As a result of this the sequencing of governance groups was adapted. Papers are created by a bespoke algorithm. 

Results 

The change in sequencing will be outlined in the presentation. 

Discussion
One of the biggest challenges identified through the first large-scale pilot of the AKT was ensuring the items in the exam are fit for purpose. The governance system was changed to ensure that as many experts as possible looked at the items before they were standard set. Both the Exam Construction Group and the AKT Exam Board are now allotted significant time to review items.


Conclusions

The item writing process is rigorous and each item is subject to review additional QA provides further insight into the items and the overall structure of individual exams.


Take-home messages / implications for further research or practice
Robust QA of items is essential in the delivery of a national exam as an effective governance and oversight process. Acting at scale requires a different approach to the delivery of exams in a single institution once a year. 

References (maximum three) 

MSC website - https://www.medschools.ac.uk/our-work/medical-licensing- assessment accessed August 2023