How personalised support is helping GP trainees pass re-sits of the CSA and AKT

New ways of preparing for the MRCGP have dramatically improved the success rates of GP trainees re-sitting their exams.

Pictured l-r: Dr Anne Hawkridge, Dr Mark Coombe, Dr Bob Kirk. Credit: Sam Atkins

Candidates for the Clinical Skills Assessment (CSA) and Applied Knowledge Test (AKT) in Health Education England’s North West region are being supported with personal analysis of their educational needs and a blend of face-to-face and online learning.

Each GP trainee re-sitting the CSA was appraised with a tool created by MRCGP examiners to help identify problem behaviours. They then met with their educational supervisor alongside another GP educator, and together produced an educational plan aligned to their needs.

Of the 33 trainees re-sitting the CSA in 2016, 76% passed in subsequent examination attempts. Those candidates attempting the CSA for the 3rd or 4th time achieved a combined pass rate of 79%. The national rate for 3rd and 4th attempts was 46%. 

CSA pass rates exceed national average

When the group was divided by source of primary medical qualification, UK graduates achieved an 80% pass rate for 3rd attempts and 100% for 4th attempts, compared to national rates of 65.9% and 53.8% respectively. Non-UK graduates achieved a 71.4% pass rate for 3rd attempts and 83% for 4th attempts compared to national rates of 44.3% and 40.5% respectively.

Co-author of the CSA Tool Dr Anne Hawkridge said: ‘The success of the CSA programme lay in the skills of the educators using a generic tool which allowed calibration and planning of educational strategies. Trainees also greatly valued the personalised support and a means of evaluating their own progress.’

Deputy Dean for the North West Dr Bob Kirk said ‘super educators’ had been recruited from across the region to be trained in using the CSA Tool: ‘The 2016 results were extremely positive and we are confident that dissemination of the teachings and resources across the region will continue to energise exam preparation and produce exam success.’

Focused revision for AKT

A new online preparation package for the AKT was also introduced in August 2016 offering focused revision guided by self-assessment, written by MRCGP examiner Dr Mark Coombe in collaboration with appraisal toolkit provider FourteenFish

GP trainees re-sitting the AKT were invited to an intensive one-day course and received individual feedback on how to maximise their use of the package. They were also invited to an online forum with other re-sit doctors across the North West to reduce isolation and provide peer support. 

Dr Coombe said: ‘One of the biggest misconceptions in AKT preparation is that joining a large question bank and doing lots of mock questions will get you through the exam. This is just not true. Doing questions should guide learning. Failing can have devastating psychological consequences for any learner and in particularly for doctors with no previous experience of assessment failure. Our package has offered an individually tailored approach, enabling many to move to a pass.’

The impressive performance data from the FourteenFish ‘Pass the AKT’ package means that it is now offered to all GPs in training in the North West region.

The new approach was presented at the Developing Excellence in Medical Education Conference in Manchester.

References: All exam statistics from the MRCGP Annual Report 2015/16

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