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:
MRCP(UK) PACES examination assesses the clinical knowledge, behaviours and skills of trainee doctors who aim to enter physician higher specialist training. Seven skills are assessed in five stations (1-5): 1:Respiratory and Abdominal examinations, 2:History taking, 3:Cardiovascular and Neurological examinations, 4:Communication skills and ethics, 5:Two brief clinical consultations. Pre-COVID, assessments were delivered in-person in a hospital ward or postgraduate education centre, using patients and surrogates. During the pandemic, the format of stations 2&4 was changed to remote assessment to introduce social distancing. Candidates were examined in a separate same-day mini-carousel via a video link to the surrogates and examiners. The other stations remained unchanged.
MRCP(UK) PACES examination assesses the clinical knowledge, behaviours and skills of trainee doctors who aim to enter physician higher specialist training. Seven skills are assessed in five stations (1-5): 1:Respiratory and Abdominal examinations, 2:History taking, 3:Cardiovascular and Neurological examinations, 4:Communication skills and ethics, 5:Two brief clinical consultations. Pre-COVID, assessments were delivered in-person in a hospital ward or postgraduate education centre, using patients and surrogates. During the pandemic, the format of stations 2&4 was changed to remote assessment to introduce social distancing. Candidates were examined in a separate same-day mini-carousel via a video link to the surrogates and examiners. The other stations remained unchanged.
Summary of work:
The main question asked whether totalled scores for Skill C:Clinical Communication, and Skill F:Managing Patients’ Concerns, differed for stations administered remotely during COVID compared with in-person stations from before COVID. Participants were UK trainees sitting PACES for the first time, 5,274 in 2017-2019 (pre-COVID) and 2,074 during the pandemic.
The main question asked whether totalled scores for Skill C:Clinical Communication, and Skill F:Managing Patients’ Concerns, differed for stations administered remotely during COVID compared with in-person stations from before COVID. Participants were UK trainees sitting PACES for the first time, 5,274 in 2017-2019 (pre-COVID) and 2,074 during the pandemic.
Results:
Overall scores on stations 2&4 and 5 were slightly but non-significantly lower during COVID, but as is usual in PACES, scores on station 5 were higher than those on stations 2&4. The key analysis used ANOVA to show that there was no significant interaction of station by COVID (p=0.852), indicating that testing stations 2&4 remotely during COVID, compared with station 5 which remained in-person, did not alter candidates relative scores.
Overall scores on stations 2&4 and 5 were slightly but non-significantly lower during COVID, but as is usual in PACES, scores on station 5 were higher than those on stations 2&4. The key analysis used ANOVA to show that there was no significant interaction of station by COVID (p=0.852), indicating that testing stations 2&4 remotely during COVID, compared with station 5 which remained in-person, did not alter candidates relative scores.
Discussion:
COVID did not alter the pattern of scores on communication skills when stations 2&4 were tested remotely as compared with being tested in-person as a part of the normal carousel.
COVID did not alter the pattern of scores on communication skills when stations 2&4 were tested remotely as compared with being tested in-person as a part of the normal carousel.
Conclusion:
Remote assessment of clinical skills in communication stations had little impact on UK trainees’ performance.
Remote assessment of clinical skills in communication stations had little impact on UK trainees’ performance.
Take-home messages:
Remote assessment of clinical skills is practical under special circumstances but it should be fit for purpose ensuring that high standards are maintained.
Remote assessment of clinical skills is practical under special circumstances but it should be fit for purpose ensuring that high standards are maintained.
References (maximum three)
1.S. Lara, C.W. Foster, M. Hawks and M. Montgomery. “Remote Assessment of Clinical Skills During COVID-19: A Virtual, High-Stakes, Summative Pediatric Objective Structured Clinical Examination.” Acad Pediatr. 2020 Aug; 20(6): 760–761. Published online 2020 Jun 5. doi: 10.1016/j.acap.2020.05.029 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273144/