The influence of candidates' race on examiners' ratings in standardised assessments of clinical practice.

Purpose: Delivering fair and reliable summative assessments in medical education assumes examiner decision making is devoid of bias. We investigated whether candidate racial appearances influenced examiner ratings in undergraduate clinical exams.

Methods: We used an internet-based design.

UK Prescribing Safety Assessment (PSA): The development, implementation and outcomes of a national online prescribing assessment.

Aims: The United Kingdom (UK) Prescribing Safety Assessment (PSA) is a 2-h online assessment of basic competence to prescribe and supervise the use of medicines. It has been undertaken by students and doctors in UK medical and foundation schools for the past decade. This study describes the academic characteristics and performance of the assessment; longitudinal performance of candidates and schools; stakeholder feedback; and surrogate markers of prescribing safety in UK healthcare practice.

A collaboration on teaching and assessing triadic consultation skills.

Introduction: Teaching triadic consultation skills is becoming increasingly prevalent at medical schools but is included by few schools in summative assessments. We describe a collaboration between Leicester and Cambridge Medical Schools to share teaching practice and the development of an objective structure clinical examination (OSCE) station to assess these important skills.

Methods: We agreed on the broad components of the process skills of a triadic consultation and wrote a framework.

The impact of patient skin colour on diagnostic ability and confidence of medical students.

Previous literature has explored unconscious racial biases in clinical education and medicine, finding that people with darker skin tones can be underrepresented in learning resources and managed differently in a clinical setting. This study aimed to examine whether patient skin colour can affect the diagnostic ability and confidence of medical students, and their cognitive reasoning processes. We presented students with 12 different clinical presentations on both white skin (WS) and non-white skin (NWS).

Standard setting Very Short Answer Questions (VSAQs) relative to Single Best Answer Questions (SBAQs): does having access to the answers make a difference?

Background: We investigated whether question format and access to the correct answers affect the pass mark set by standard-setters on written examinations.

Methods: Trained educators used the Angoff method to standard set two 50-item tests with identical vignettes, one in a single best answer question (SBAQ) format (with five answer options) and the other in a very short answer question (VSAQ) format (requiring free text responses). Half the participants had access to the correct answers and half did not.

Twelve tips for introducing very short answer questions (VSAQs) into your medical curriculum.

Most undergraduate written examinations use multiple-choice questions, such as single best answer questions (SBAQs) to assess medical knowledge. In recent years, a strong evidence base has emerged for the use of very short answer questions (VSAQs). VSAQs have been shown to be an acceptable, reliable, discriminatory, and cost-effective assessment tool in both formative and summative undergraduate assessments.

Using very short answer errors to guide teaching.

Background: Student performance in examinations reflects on both teaching and student learning. Very short answer questions require students to provide a self-generated response to a question of between one and five words, which removes the cueing effects of single best answer format examinations while still enabling efficient machine marking. The aim of this study was to pilot a method of analysing student errors in an applied knowledge test consisting of very short answer questions, which would enable identification of common areas that could potentially guide future teaching.

Are remote clinical assessments a feasible and acceptable method of assessment? A systematic review.

The COVID-19 pandemic presented an enormous and immediate challenge to assessing clinical skills in healthcare professionals. Many institutions were unable to deliver established face-to-face assessment methods such as Objective Structured Clinical Examinations (OSCEs). Assessors needed to rapidly institute alternative assessment methods to ensure that candidates met the clinical competences required for progression.

Is Academic Attainment or Situational Judgment Test Performance in Medical School Associated With the Likelihood of Disciplinary Action? A National Retrospective Cohort Study.

Purpose: Disciplinary action imposed on physicians indicates their fitness to practice medicine is impaired and patient safety is potentially at risk. This national retrospective cohort study sought to examine whether there was an association between academic attainment or performance on a situational judgment test (SJT) in medical school and the risk of receiving disciplinary action within the first 5 years of professional practice in the United Kingdom.

Method: The authors included data from the UK Medical Education Database for 34,865 physicians from 33 U.

Thinking differently - Students' cognitive processes when answering two different formats of written question.

Background: Single-best answer questions (SBAQs) are common but are susceptible to cueing. Very short answer questions (VSAQs) could be an alternative, and we sought to determine if students' cognitive processes varied across question types and whether students with different performance levels used different methods for answering questions.

Methods: We undertook a 'think aloud' study, interviewing 21 final year medical students at five UK medical schools.

National inter-rater agreement of standardised simulated-patient-based assessments.

Purpose: The forthcoming UK Medical Licensing Assessment will require all medical schools in the UK to ensure that their students pass an appropriately designed Clinical and Professional Skills Assessment (CPSA) prior to graduation and registration with a licence to practice medicine. The requirements for the CPSA will be set by the General Medical Council, but individual medical schools will be responsible for implementing their own assessments. It is therefore important that assessors from different medical schools across the UK agree on what standard of performance constitutes a fail, pass or good grade.

Comparing single-best-answer and very-short-answer questions for the assessment of applied medical knowledge in 20 UK medical schools: Cross-sectional study.

Objectives: The study aimed to compare candidate performance between traditional best-of-five single-best-answer (SBA) questions and very-short-answer (VSA) questions, in which candidates must generate their own answers of between one and five words. The primary objective was to determine if the mean positive cue rate for SBAs exceeded the null hypothesis guessing rate of 20%.

Design: This was a cross-sectional study undertaken in 2018.

Diabetic myonecrosis: A case series of two dialysis-dependent patients.

Diabetic myonecrosis (DMN) is a rare microangiopathic disorder that can present as an acutely painful and swollen limb in patients with established diabetes mellitus. The condition can be diagnosed noninvasively with magnetic resonance imaging and resolves with analgesia, bed rest, and glycemic control. Due to a relative lack of awareness regarding the condition, avoidable interventions such as muscle biopsies and even surgery are sometimes pursued, which have been associated with prolonged recovery times.

An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.

Objective: To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI).

Setting: 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people.

Osteoclastomas ('brown tumours') and spinal cord compression: a review.

Brown tumours are an uncommon manifestation of primary and secondary hyperparathyroidism. There are numerous case reports of brown tumours arising in various parts of the skeleton. They can therefore present a wide range of clinical manifestations.