Quality assurance of the Applied Knowledge Test (AKT) of the MRCGP examination - an immediate post-test questionnaire evaluation of the candidates' views.

The Applied Knowledge Test (AKT) of the Membership of the Royal College of General Practitioners (MRCGP) examination is a computer-based assessment delivered three times a year. A computerised questionnaire, administered immediately after the test, sought candidates' views as part of the test evaluation. Of 1681 candidates taking the test 1418 (84%) responded. Most candidates believed that the test assessed their knowledge of problems relevant to general practice. Their feedback highlighted areas where improvements could be made. Candidates' views of postgraduate specialty medical examinations in the UK are rarely sought or published. We are not aware of other published evidence. The use of computer-based testing enables immediate candidate feedback and can be used routinely to evaluate the test validity and formats. The views of candidates are an important component of quality assurance in reviewing the content, format and educational experience of a high-stakes examination.

Comparing performance among male and female candidates in sex-specific clinical knowledge in the MRCGP.

BACKGROUND: Patients often seek doctors of the same sex, particularly for sex-specific complaints and also because of a perception that doctors have greater knowledge of complaints relating to their own sex. Few studies have investigated differences in knowledge by sex of candidate on sex-specific questions in medical examinations. AIM: The aim was to compare the performance of males and females in sex-specific questions in a 200-item computer-based applied knowledge test for licensing UK GPs. DESIGN AND SETTING: A cross-sectional design using routinely collected performance and demographic data from the first three versions of the Applied Knowledge Test, MRCGP, UK. METHOD: Questions were classified as female specific, male specific, or sex neutral. The performance of males and females was analysed using multiple analysis of covariance after adjusting for sex-neutral score and demographic confounders. RESULTS: Data were included from 3627 candidates. After adjusting for sex-neutral score, age, time since qualification, year of speciality training, ethnicity, and country of primary medical qualification, there were differences in performance in sex-specific questions. Males performed worse than females on female-specific questions (-4.2%, 95% confidence interval [CI] = -5.7 to -2.6) but did not perform significantly better than females on male-specific questions (0.3%, 95% CI = -2.6 to 3.2%. CONCLUSION: There was evidence of better performance by females in female-specific questions but this was small relative to the size of the test. Differential performance of males and females in sex-specific questions in a licensing examination may have implications for vocational and post-qualification general practice training.

Performance and views of examiners in the Applied Knowledge Test for the nMRCGP licensing examination.

BACKGROUND: A new computer-based Applied Knowledge Test (AKT) has been developed for the licensing examination for general practice administered by the Royal College of General Practitioners. AIM: The aim of this evaluation was to assess the acceptability, feasibility, and validity of the test as well as its transfer to a computerised format at local test centres. DESIGN OF STUDY: Computer-based test and postal questionnaire. PARTICIPANTS AND SETTING: Panel of examiners, Membership of the Royal College of General Practitioners (MRCGP) examination, UK. METHOD: Self-administered postal questionnaires were sent to examiners not involved with the development of the test after completing it. Their performance scores were compared with those of candidates. RESULTS: The majority of participants (80.9%) were satisfied with the new computer-based test. Responses relating to content and attitudes to the test were also positive overall, but some problems with content were highlighted. Fewer examiners (61.9%) were positive about the physical comfort of the test centre, including seating, heating, and lighting. Examiners had significantly higher scores (mean 83.3%, range 69 to 93%, 95% confidence interval [CI] = 81.9 to 84.7%) than 'real' candidates (mean 75.0%, range 45 to 94%, 95% CI = 74.6 to 75.5%), who subsequently took an identical test. CONCLUSION: The new computer-based licensing test (the AKT) was found to be acceptable to the majority of examiners. The pass-fail standard, determined by routine methods including an Angoff procedure, was supported by the higher success rate of examiners compared with candidates. The use of selected groups to assess high-stakes (licensing) examinations can be useful for assessing test validity.