The impact of large scale licensing examinations in highly developed countries: a systematic review

Archer, Julian; Lynn, Nick; Coombes, Lee; Roberts, Martin; Gale, Thomas; Price, Tristan; Bere, Sam Regan de

doi:10.1186/s12909-016-0729-7

Cited by 45 publications

(58 citation statements)

References 48 publications

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“…Evaluation is important in determining validity of licensing examinations, which are crucial for career progression, including the consequences of the assessment for different candidate groups. A previous systematic review of licensing examinations focused on the negative consequences of differential attainment for IMGs but this is partly due to past research focusing on IMGs and the relative lack of research on performance of candidates with SpLDs or other protected characteristics, including the effects of providing reasonable adjustments.…”

Section: Introductionmentioning

confidence: 99%

Performance in candidates declaring versus those not declaring dyslexia in a licensing clinical examination

et al. 2019

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Context High‐stakes medical examinations seek to be fair to all candidates, including an increasing proportion of trainee doctors with specific learning differences. We aimed to investigate the performance of doctors declaring dyslexia in the clinical skills assessment (CSA), an objective structured clinical examination for licensing UK general practitioners. Methods We employed a cross‐sectional design using performance and attribute data from candidates taking the CSA between 2010 and 2017. We compared candidates who declared dyslexia (‘early’ before their first attempt or ‘late’ after failing at least once) with those who did not, using multivariable negative binomial regression investigating the effect of declaring dyslexia on passing the CSA, accounting for relevant factors previously associated with performance, including number of attempts, initial score, sex, place of primary medical qualification and ethnicity. Results Of 20 879 CSA candidates, 598 (2.9%) declared that they had dyslexia. Candidates declaring dyslexia were more likely to be male (47.3% versus 37.8%; p < 0.001) and to have a non‐UK primary medical qualification (26.9% versus 22.4%; p < 0.01), but were no different in ethnicity compared with those who never declared dyslexia. Candidates who declared dyslexia late were significantly more likely to fail compared with those candidates who declared dyslexia early (40.6% versus 9.2%; p < 0.001) and were more likely to have a non‐UK medical qualification (79.3% versus 15.6%; p < 0.001) or come from a minority ethnic group (84.9% versus 39.2%; p < 0.001). The chance of passing was lower for candidates declaring dyslexia compared to those who never declared dyslexia and lower in those declaring late (incident rate ratio [IRR], 0.82; 95% confidence interval [CI], 0.70–0.96) compared with those declaring early (IRR, 0.95; 95% CI, 0.93–0.97). Conclusions A small proportion of candidates declaring dyslexia were less likely to pass the CSA, particularly if dyslexia was declared late. Further investigation of potential causes and solutions is needed.

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Section: Introductionmentioning

confidence: 99%

Performance in candidates declaring versus those not declaring dyslexia in a licensing clinical examination

et al. 2019

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“…We developed the survey based on these writings. [2][3][4][5][6][7][8]13,[16][17][18][19] While reading the source materials, we took note of the concepts that those authors considered most important to professionalization, those that were most often misidentified as facts about professionalization, and the main stakeholder groups affected by QEs. The notes from these sources were used to create open-ended questions for our survey about perceptions of the benefits, myths, barriers, solutions, the future, and opinions regarding CQEs.…”

Section: Design Of the Questionnairementioning

confidence: 99%

“…Given the high stakes and wide range of stakeholders, it is unsurprising that such exams are a source of contention. 13 These issues are not unique to chiropractic but exist as concerns for other healthcare professions that require a QE. 1,12 However, in the chiropractic profession, there are additional important issues to consider with regard to CQEs.…”

Section: Introductionmentioning

confidence: 99%

An international stakeholder survey of the role of chiropractic qualifying examinations: A qualitative analysis

Green¹,

Johnson²,

Brown³

et al. 2020

Journal of Chiropractic Education

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Objective: Many countries require examinations as a gateway to chiropractic licensure; however, the relevance of these exams to the profession has not been explored. The purposes of this study were to analyze perceptions of international stakeholders about chiropractic qualifying examinations (CQEs), observe if their beliefs were in alignment with those that society expects of professions, and suggest how this information may be used when making future decisions about CQEs. Methods: We designed an electronic survey that included open-ended questions related to CQEs. In August 2019, the survey was distributed to 234 international stakeholders representing academic institutions, qualifying boards, students, practitioners, association officers, and others. Written comments were extracted, and concepts were categorized and collapsed into 4 categories (benefits, myths, concerns, solutions). Qualitative analysis was used to identify themes. Results: The response rate was 56.4% representing 43 countries and yielding 775 comments. Perceived benefits included that CQEs certify a minimum standard of knowledge and competency and are part of the professionalization of chiropractic. Myths included that CQEs are able to screen for future quality of care or ethical practices. Concerns included a lack of standardization between jurisdictions and uncertainty about the cost/value of CQEs and what they measure. Solutions included suggestions to standardize exams across jurisdictions and focus on competencies. Conclusion: International stakeholders identified concepts about CQEs that may facilitate or hinder collaboration and efforts toward portability. Stakeholder beliefs were aligned with those expected of learned professions. This qualitative analysis identified 9 major themes that may be used when making future decisions about CQEs.

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“…Such developments reside in the backdrop of long-standing debates regarding the prudence of such a decision and the closely connected idea of introducing a European licensing examination (Noble, 2008;Ricketts & Archer, 2008;van der Vleuten, 2009;Archer et al, 2016) with similar issues being raised in each case.…”

Section: Introductionmentioning

confidence: 99%

“…However, much of this work has comprised opinion pieces. These opinion pieces have favoured the initiative (Ricketts, 2008) or, as with a systematic review involving "highly developed countries" (Archer et al, 2016), highlighted the apparent lack of an evidence base for confirming some of the alleged benefits of the UKMLA (Noble, 2008;Allawi et al, 2015), including improved graduate competency to practise and an increase in patient safety. Other work has presented both sides of the debate based on isolated quotes from a selection of medical graduates or educational researchers in the absence of a convincing sampling frame (Rimmer, 2014).…”

Section: Introductionmentioning

confidence: 99%

Concerns that Linger: Medical School Perspectives on the UKMLA and Shared Assessment

MacDougall¹

2018

JED

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The General Medical Council have closed their formal consultation process soliciting recommendations on how to develop a UK Medical Licensing Assessment (UKMLA). The output of this consultation goes a considerable way to identifying concerns about implementation of such an assessment. However, there is scope for more attention to detail in specifying concerns held by individual UK medical schools, even where these schools have indicated acceptance or approval of the UKMLA. There is therefore a need for increased transparency in identifying stakeholder viewpoints to ensure these lingering concerns can be addressed during the current development phase. The current study contributes to addressing this need through providing an overview of UK medical school views on introducing a UKMLA and relatedly, on shared assessment as a source of uniformity of competency across medical schools. Using a secure online survey system, response data were collected during 13-30 January, 2014 from recommended assessment specialists, representing their respective medical schools. Likert scale and free text response data were collected. Based on Likert sale data, more medical schools appeared accepting of these ideas than either those who expressed disapproval or those who expressed uncertainty. Nevertheless, concerns still lingered. Areas of concern included stifling of curriculum innovation, supporting students who fail the UKMLA and quality and administration of assessment. Eleven recommendations have emerged for addressing respondent concerns. In presenting these recommendations arising specifically from participant feedback, I invite responses from all categories of stakeholder in order to promote open discussion beyond the formal consultation period.

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The impact of large scale licensing examinations in highly developed countries: a systematic review

Cited by 45 publications

References 48 publications

Performance in candidates declaring versus those not declaring dyslexia in a licensing clinical examination

Performance in candidates declaring versus those not declaring dyslexia in a licensing clinical examination

An international stakeholder survey of the role of chiropractic qualifying examinations: A qualitative analysis

Concerns that Linger: Medical School Perspectives on the UKMLA and Shared Assessment

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