Examiner perceptions of the UK Recorded Consultation Assessment introduced during the COVID-19 pandemic: cross-sectional study

Conference:

SAPC ASM 2021 - virtual

Talk Code:

P1.19.03

Presenter:

Prof Aloysius Niroshan Siriwardena

Twitter:

@nsiriwardena

Co-authors:

Vanessa Botan, Despina Laparidou, Viet-Hai Phung, Peter Cheung, Adrian Freeman, Richard Wakeford, Meiling Denney, Graham R Law

Author institutions:

University of Lincoln, Royal College of General Practitioners, University of Exeter, University of Cambridge

Problem

Objective structured clinical examinations (OSCEs) for high stakes licensing assessments have had to be adapted to reduce risks to candidates, examiners and patients or simulators from COVID-19, and to allow trainees join the medical workforce. The Recorded Consultation Assessment (RCA) was rapidly piloted to replace the Clinical Skills Assessment (CSA) OSCE for UK general practice licensing during the pandemic. We aimed to investigate examiner perceptions of the RCA.

Approach

We used a cross-sectional survey of RCA examiners with attitudinal, demographic and free text response options. We conducted descriptive statistical and factor analysis of quantitative data using Stata 15.1 and qualitative thematic analysis for free text responses supported by NVivo 12.

Findings

Overall, 182 of 260 (70%) examiners completed the questionnaire. Responders felt that consultations submitted were representative of the work of a typical GP during the pandemic and provided a good sample of cases across the curriculum. They were also generally positive about the logistic, advisory, and other support provided, as well as the digital platform. Despite responders generally agreeing there was enough information available in video or audio consultations to judge candidates’ data gathering, clinical management, and interpersonal skills, they were less confident about their ability to make judgments of candidates’ performance compared to the CSA. The qualitative analysis of free text responses detailed the problems of case selection and content, explained examiners’ difficulties when making judgments, and detailed the generally positive views about support, training, and information technology. Responders also provided helpful recommendations for improving the assessment.

Consequences

The RCA was feasible and broadly acceptable, although examiners experienced challenges of case selection, case content and judgments and suggested areas for improvement.

Submitted by:

Aloysius Siriwardena

Funding acknowledgement:

Royal College of General Practitioners