Presentation Description
Gerrard Phillips1
Chris McManus2 and Liliana Chis3
1 Executive Medical Director, The Federation of Royal Colleges of Physicians of the United Kingdom
2 Emeritus Professor, Research Department, University College London
3 MRCP(UK)
Chris McManus2 and Liliana Chis3
1 Executive Medical Director, The Federation of Royal Colleges of Physicians of the United Kingdom
2 Emeritus Professor, Research Department, University College London
3 MRCP(UK)
Background:
PACES assesses the clinical knowledge, behaviours and skills of trainee doctors who intend to enter higher specialist training in the physician specialties. The PACES carousel has five clinical stations, each having one or two encounters, eight encounters overall. Seven physician skills (A-G) are assessed: A: Physical Examination, B: Identifying Physical Signs, C: Clinical Communication, D: Differential Diagnosis, E: Clinical Judgement, F: Managing Patients’ Concerns, G: Maintaining Patient Welfare. Two examiners at each station mark candidates independently. Overall, candidate performance in each skill will have been independently assessed between 8 and 16 times. Candidates need to achieve a minimum passing score in each skill plus achieve an overall total score of 130 (maximum: 176) to pass.
PACES assesses the clinical knowledge, behaviours and skills of trainee doctors who intend to enter higher specialist training in the physician specialties. The PACES carousel has five clinical stations, each having one or two encounters, eight encounters overall. Seven physician skills (A-G) are assessed: A: Physical Examination, B: Identifying Physical Signs, C: Clinical Communication, D: Differential Diagnosis, E: Clinical Judgement, F: Managing Patients’ Concerns, G: Maintaining Patient Welfare. Two examiners at each station mark candidates independently. Overall, candidate performance in each skill will have been independently assessed between 8 and 16 times. Candidates need to achieve a minimum passing score in each skill plus achieve an overall total score of 130 (maximum: 176) to pass.
Summary of work:
Using a retrospective longitudinal cohort sample of 9,018 first attempt UK trainees sitting PACES in 2017-2022, we investigated the impact of PMQ, gender and ethnicity on the pass rate in each of the seven skills. We also applied a multivariate analysis to explore how passing MRCP(UK) Part 1 and Part 2 written examinations at first attempt, PMQ, gender and ethnicity predict passing PACES overall.
Using a retrospective longitudinal cohort sample of 9,018 first attempt UK trainees sitting PACES in 2017-2022, we investigated the impact of PMQ, gender and ethnicity on the pass rate in each of the seven skills. We also applied a multivariate analysis to explore how passing MRCP(UK) Part 1 and Part 2 written examinations at first attempt, PMQ, gender and ethnicity predict passing PACES overall.
Results:
The highest pass rate was in Skill G and the lowest in Skill B. Compared with their counterparts, females, white candidates and UK graduates achieved higher pass rates in all clinical skills and in Part 1 and Part 2 written examinations when sitting for the first time. Passing Part 1 and Part 2 written examinations at first attempt is also a predictor of passing PACES.
The highest pass rate was in Skill G and the lowest in Skill B. Compared with their counterparts, females, white candidates and UK graduates achieved higher pass rates in all clinical skills and in Part 1 and Part 2 written examinations when sitting for the first time. Passing Part 1 and Part 2 written examinations at first attempt is also a predictor of passing PACES.
Discussion:
Differential attainment in clinical skills performance is a complex multifaceted issue which needs exploring further.
Differential attainment in clinical skills performance is a complex multifaceted issue which needs exploring further.
Conclusion:
Being female, white, UK graduate and passing written examinations at first attempt are good predictors for PACES success.
Being female, white, UK graduate and passing written examinations at first attempt are good predictors for PACES success.
Take-home messages:
Differential attainment in clinical exams is a significant issue that needs further investigation.
Differential attainment in clinical exams is a significant issue that needs further investigation.
References (maximum three)
1. Woolf K. “Differential attainment in medical education and training.” BMJ; 2020, 368:m339. https://www.bmj.com/content/368/bmj.m339
1. S. Rupal and S. Ahluvalia. “The challenges of understanding differential attainment in postgraduate medical education.” British Journal of General Practice 2019; 69 (686): 426-427. DOI:https://doi.org/10.3399/bjgp19X705161. https://bjgp.org/content/69/686/426