1. Changes to the Final FRCA Exam

2. Changes to the Final Written
Constructed Response Questions (CRQs) replacing Short Answer Questions (SAQs)
Reduce possibility of misinterpretation
More focussed marking system
Awarding of marks more transparent
Increase in reliability and validity
Easier to adapt to Computer Based Testing
The examiner board felt that moving the FRCA SAQ examination to a more structured form, for both questions and answers, would reduce the possibility of misinterpretation of either which will be beneficial to both examiner and candidate. The marking system would be more focussed having tiered sub-questions with clear mark allocations alongside which would allow greater transparency in how marks have been awarded. This type of system is considered good practice in further and higher educational boards. The adoption of this format should see an increase in reliability and validity of this part of the Final Written examination. This change of question format will continue to reflect the knowledge required in clinical practice and allow whole Curriculum assessment. The more direct question and answer format would also be more easily adaptable to computer based testing which should see an increase in effectiveness and improve the service offered to candidates.

3. Final Written timeline
Constructed Response Questions (CRQs) replacing Short Answer Questions (SAQs)
First exam September 2019:
6 x CRQ (1-6) and 6 x SAQ (7-12) in 3 hours
Both sets of questions carry 20 marks each
Plan move to all CRQ in March 2020
Chair’s report and example questions on website.

4. changes to the Final SOE Dec 18
1. Introduction of an extra table change so that candidates will see six examiners 2. SOE1 - AM - Four clinical short cases each one linked to an applied clinical science question 3. SOE2 - PM - Two part long case and two stand-alone short cases

5. Reason for change
More examiners reduces possibility of subjectivity and increases validity and reliability
Short with linked applied clinical science more intuitive
Shorter long case allows greater breath of the curriculum overall

6. SOE1 - Short with linked Science (AM)
Two parts A and B taken in one sitting
Each part consists of two short cases each with linked science questions in 26 mins
Normally, clinical short case followed by a linked science question – 13 minutes
Occasionally the linked science question will be covered first

7. Part A
Short 1 science 1
Science 3 Short 3
Short 4
Science 4
Part B
Short 2 science 2

8. SOE 2 – Clinical Anaesthesia - PM
10 minutes to review material in long case
Long case (13 minutes) two parts:
Pre-op – assessment
Intra-op – Management
Two clinical short cases (13 minutes)
Two further examiners – six in total

9. Marks available – giving results
2 marks for each question/section 8 question SOE1 and 4 section/questions SOE2 X 2 examiners = 48 marks
No fixed pass mark – pass mark assessed for each day using Borderline regression (BLR) and examiner review of borderline candidate scores. Sense check using Hofstee
Results on fixed date using pass-fail list – followed by result letters.

10. Standard setting process
The borderline regression method will be the primary standard setting method
A sense check will be carried out using the Hofstee method
Examiner board review borderline candidates
The ultimate responsibility for setting the pass mark will reside with the chair and board of examiners.
In all cases, it is essential that the process is transparent and clearly recorded

11. marking and global scoring
The marking sections will be split across four marking sheets:
SOE1 - Part A (16 marks),
SOE1 - Part B (16 marks),
SOE2 - Long case (8 marks),
SOE2 - Short cases (8 marks),
Therefore, there will be four global scores allocated for each candidate.

12. Global scoring Descriptors
Global rating
Descriptor
Excellent
[5]
Excellent knowledge, application and confidence.
I.e. worthy of a prize.
Clear Pass
[4]
Very good knowledge.
Any minor omissions did not detract from the overall performance.
Examiner more than satisfied that candidate was proficient across topics covered.
Pass
[3]
Demonstrated an adequate level of knowledge and understanding.
Some omissions and inaccuracies occurred in their performance.
Some evidence of flexibility of approach with acceptable interaction with examiners.
Safe to progress.
Borderline
[2]
Patchy knowledge overall.
Demonstrated only just enough level of essential skill and understanding. However, omissions and inaccuracies occurred in their performance.
Often formulaic in approach and at times hesitated or prompted to answer.
Examiner undecided whether to pass or fail candidate.
Fail
[1]
Failed to demonstrate competence with a clinical approach that is incompatible with accepted practice.
Their performance may show inadequate reasoning and incorrect management or treatment likely to result in serious and untoward patient outcome.
Appeared disorganised.
Unsafe and unsuitable to progress.

13. Advantages of BLR Reliable results: BLR uses real exam data
Used widely by all Medical Colleges and the GMC
Identifies questions issues: BLR is an effective way of identifying problems. Poorly performing questions will be identified the cut score will be lower.
The awarding of global scores for candidates is not time consuming and once familiar with the global score descriptors it will become an intuitive process.
Regular training and benchmarking exercises will be given.

14. Contact the examinations department
Any questions?
Contact the examinations department