UEMS-CESMA Exam survey 2014
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1 UEMS-CESMA Exam survey 2014 John Boorman European Board of Plastic, Reconstructive & Aesthetic Surgery Innsbruck 24 th May 2014
2 Content Results of survey of current practice Discussion on MCQ exam pass mark setting using data from EBOPRAS examinations
3 The survey Sent to all Boards represented at CESMA 28 replies received 10 Boards did not reply Gynaecology Nephrology Neuroradiology Nuclear Medicine Oro-Maxillo- Facial Surgery Paediatric Cardiology Paediatrics Radiology Respiratory Medicine Transplant Surgery
4 Responses received from 28 Sections Anaesthesiology Angiology/Vascular Medicine Cardiology Dermatology and Venereology Emergency Medicine Gastroenterology & Hepatology Hand Surgery Infectious Diseases Intensive Care Medicine Medical Biopathology Neurology Neurosurgery Occupational Medicine Ophthalmic Surgery ORL-HNS Orthopaedics and Trauma Paediatric & Neonatal Intensive Care Paediatric Surgery Paediatric Urology Pathology Physical and Rehabilitation Medicine Plastic Surgery Rheumatology Surgery Thoracic Suregry Urological Surgery Vascular Surgery Internal Medicine
5 Sections (not) holding summative exams Anaesthesiology Angiology/Vascular Medicine Cardiology Dermatology and Venereology Emergency Medicine Gastroenterology & Hepatology Hand Surgery Infectious Diseases Intensive Care Medicine Medical Biopathology Neurology Neurosurgery Occupational Medicine Ophthalmic Surgery ORL-HNS Orthopaedics and Trauma Paediatric & Neonatal Intensive Care Paediatric Surgery Paediatric Urology Pathology Physical and Rehabilitation Medicine Plastic Surgery Rheumatology Surgery Thoracic Surgery Urological Surgery Vascular Surgery Internal Medicine
6 26 European Board Exams Anaesthesia and Intensive Care Angiology/Vascular Medicine Cardiology KBA Cardiovascular Imaging CMR Exam Dermatology and Venereology Electrophysiology Emergency Medicine ENT-ORL Gastroenterology General Surgery Hand Surgery Intensive & Acute Cardiac Care Neurology Neurosurgery Ophthalmology Orthopaedics Paediatric and Neonatal Intensive Care Paediatric Urology Pathology Pediatric surgery Physical and Rehabilitation Medicine Plastic Surgery Thoracic Surgery (EBTS) Urology Vascular Surgery (FEBVS)
7 20 Admit non-uems candidates 6 Do not Anaesthesia and Intensive Care Angiology/Vascular Medicine Cardiology KBA Cardiovascular Imaging CMR Exam Dermatology and Venereology Electrophysiology Emergency Medicine ENT-ORL Gastroenterology General Surgery Hand Surgery Intensive & Acute Cardiac Care Neurology Neurosurgery Ophthalmology Orthopaedics Paediatric and Neonatal Intensive Care Paediatric Urology Pathology Pediatric surgery Physical and Rehabilitation Medicine Plastic Surgery Thoracic Surgery (EBTS) Urology Vascular Surgery (FEBVS)
8 24 Include an MCQ 2 Do not Anaesthesia and Intensive Care Angiology/Vascular Medicine Cardiology KBA Cardiovascular Imaging CMR Exam Dermatology and Venereology Electrophysiology Emergency Medicine ENT-ORL Gastroenterology General Surgery Hand Surgery Intensive & Acute Cardiac Care Neurology Neurosurgery Ophthalmology Orthopaedics Paediatric and Neonatal Intensive Care Paediatric Urology Pathology Pediatric surgery Physical and Rehabilitation Medicine Plastic Surgery Thoracic Surgery (EBTS) Urology Vascular Surgery (FEBVS)
9 16 Are held at a single venue 10 Use multiple simultaneous venues Anaesthesia and Intensive Care Angiology/Vascular Medicine Cardiology KBA Cardiovascular Imaging CMR Exam Dermatology and Venereology Electrophysiology Emergency Medicine ENT-ORL Gastroenterology General Surgery Hand Surgery Intensive & Acute Cardiac Care Neurology Neurosurgery Ophthalmology Orthopaedics Paediatric and Neonatal Intensive Care Paediatric Urology Pathology Pediatric surgery Physical and Rehabilitation Medicine Plastic Surgery Thoracic Surgery (EBTS) Urology Vascular Surgery (FEBVS)
10 19 exams are in English only 5 use multiple languages Anaesthesia and Intensive Care Angiology/Vascular Medicine Cardiology KBA Cardiovascular Imaging CMR Exam Dermatology and Venereology Electrophysiology Emergency Medicine ENT-ORL Gastroenterology General Surgery Hand Surgery Intensive & Acute Cardiac Care Neurology Neurosurgery Ophthalmology Orthopaedics Paediatric and Neonatal Intensive Care Paediatric Urology Pathology Pediatric surgery Physical and Rehabilitation Medicine Plastic Surgery Thoracic Surgery (EBTS) Urology Vascular Surgery (FEBVS)
11 19 exams are in English only 6 provide no translation help Neurology Angiology/Vascular Medicine Neurosurgery Cardiology KBA Orthopaedics CMR Exam Dermatology and Venereology Emergency Medicine ENT-ORL Gastroenterology General Surgery Hand Surgery Intensive & Acute Cardiac Care Paediatric and Neonatal Intensive Care Paediatric Urology Pathology Pediatric surgery Physical and Rehabilitation Medicine Plastic Surgery Thoracic Surgery (EBTS) Vascular Surgery (FEBVS)
12 Exam size and language (MCQ) # of exams Candidates per exam English only Multiple languages Why? Larger specialties have more experts to draw on? More candidates reduce overall costs of translation etc.? Native language encourages candidates to apply?
13 Exam size and computer use # of exams Candidates per exam Paper hand marked Paper scanner marked Computer based
14 Paper vs Computer First Computer based EBOPRAS exam Survey of all 28 resit candidates Expressed preference Candidates Respond Computer Paper Total Were these all candidates who passed second time around?
15 Paper vs Computer First Computer based EBOPRAS exam Survey of all 28 resit candidates Expressed preference Candidates Respond Computer Paper Total Pass Fail
16 Advantages of computer Multimedia questions possible Flexibility in number of questions No risk of errors copying answers onto sheet Time remaining constantly displayed Results available quickly Candidates prefer it
17 Computer systems used 10 Pearson Vue 4 Orzone 3 Prometric 1 QuestionMark 1 Proprietary system 1
18 Analysis of paper-based exams 15 No software used 4 Speedwell 2 Austrian software 1 University of Heidelberg 1 Contracted statistician 1 No answer 6
19 Setting the pass mark Methos used (24) Angoff/modified 7 Fixed (typically 60%) 7 Mean 1 SD 4 75% of best 5 candidates 2 Examiner vote 1 Not clearly specified 3
20 Does the method affect the result? Analysis of last 9 EBOPRAS MCQ exams candidates per exam
21 80% Different methods to calculate EBOPRAS pass mark P A S S M A R K 75% 70% 65% 60% 55% 50% Angoff Mean-1SD 75% Top5 45% 40%
22 Effect on % of EBOPRAS candidates passing 100% 90% % P a s s i n g 80% 70% 60% Angoff Mean - 1 SD 75% Top5 50% 40%
23 Is examinee standard consistent from exam to exam? Analysis of 13 EBOPRAS MCQ exams Many questions used > once Compared performance of the different candidate groups on those identical questions at different exams
24 Is examinee standard consistent from exam to exam? Exams (in order of candidates ability) Number of question Comparisons Difference in Candidates % score Range is 3.89% Enough to have major effect on pass rates Is this a drift over time?
25 Is examinee standard consistent from exam to exam? Exams (in order of candidates ability) Number of question Comparisons Difference in Candidates % score Range is 3.89% Exams in time order Difference in Candidates % score Enough to have major effect on pass 2 rates
26 Average ability of candidate groups varies Many possible changes may affect this: Trainees admitted Non-UEMS candidates admitted Exam becoming compulsory for trainees Job market pressures Movement around EU countries Is (Mean 1SD) fair for a competence exam?
27 The Top 5 also creates problems 2 Boards using this have 80 & 350 candidates Why top 5? Is top 5% fairer? A few very good candidates can skew the outcome Is (75% of Top 5 marks) a fair pass mark?
28
29 How should we set pass mark? Comparison with previous results if questions have been used often enough definition of competence is constant over time Expert definition of minimum level of competence using (modified) Angoff procedure
30 Summary 1 Most (20/26) admit non-uems candidates Almost all (24/26) have an MCQ component Most (19/26) MCQ exams are in English only Most (16/26) are at a single venue Most (15/25) are paper-based Larger exams tend to Use multiple languages Offer multiple sites Be computer-based Candidates prefer computer-based exams
31 Summary 2 Many computer systems in use To deliver exam To analyse results Pass marks are set by many methods, which produce markedly different outcomes Candidate groups vary in their overall ability Use criterion based setting of pass marks, such as Angoff procedure
32 Future possibilities Extend the survey to greater depth/width? Can Boards collaborate more? CESMA to make recommendations on aspects of MCQ exams? Pass mark setting Computer use Languages
33 Thank you for your attention Faleminderit shumë (Albanian) Shterakravetsun (Armenian) Eskerrik asko (Basque) Mnogo blagodarya (Bulgarian) Dzãkujã (Cassubian) Moltes gràcies (Catalan) Merastawhy (Cornish) À ringraziavvi (Corsican) Hvala lijepa (Croatian) Dĕkuji (Czech) Mange tak (Danish) Dank u wel (Dutch) Thank you (English) Ic sæcge eow Þancas (English, old) Dankon al vi (Esperanto) Aitäh (Estonian) Paljon kiitoksia (Finnish) Merci beaucoup (French) Tanke wol (Frisian) Graciis (Friulian) Grazas (Galician) Mèrczi (Gallo) Merci (Gascon) Besten dank (German) Merci villmahl (German: Zurich Switzerland) Ευχαριστώ (Greek) Toda raba (Hebrew) Nagyon köszönöm (Hungarian) Takk fyrir (Icelandic) Gratias (Interlingua) Qujanaq (Inuttut) Go raibh mile maith agaibh (Irish Gaelic) Gratias tibi ago (Latin) Liels paldies (Latvian) Mouchou gratzia (Lingua Franca) Labai achiu (Lithuanian) Merci (Luxembourgish) Grazzi hafna (Maltese) Gura mie mooar ayd (Manx) Merçì (Monegasque) Gràzzie (Napulitano) Dziękuję (Polish) Obrigado (Portuguese) Mercé plan (Provencal) Nais tuke (Romani: gypsy) Oven saste (Romani) Mulţumesc (Romanian) Grazia fitgun (Romantsch) Спасибо (Russian) Giitus eanat (Saami Lappish) Moran taing (Scottish Gaelic) Grazzii (Sicilian) Dakujem vám (Slovak) Hvala lepa (Slovenian) Dz akujo so (Sorbian) Muchas gracias (Spanish) Dankeschee (Swabian) Tackar så mycket (Swedish) Çok tesekkür ederim (Turkish) Moltes gracies (Valencian) Merci (Walloon) Diolch yn fawr iawn (Welsh) A dank aych (Yiddish)
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