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ACEM fellowship exams - an overview of marking

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ACEM fellowship exams - an overview of marking

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  • I have found your program really helpful. It is so easy to understand. It makes far more sense than school teachers ever did. I desperately need a 'C' grade and with your package, I am bang on this pass rate. With a bit more revision, it will be a comfortable pass. Thanks Jeevan! ★★★ http://t.cn/AirraVnG
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ACEM fellowship exams - an overview of marking

  1. 1. ACEM Fellowship Exams A brief overview of the structure of the exams and how they are marked
  2. 2. What this talk is not…. • Comprehensive study guide • All encompassing list of tips and tricks to preparing for study and ACEM exams • Detailed insider knowledge and cumulated experience of many successful candidates If you want all that – you need to come to SCGH ED Fellowship Teaching sessions Thursdays 1030
  3. 3. Denial of responsibility • I am a – DEMT – ACEM examiner – FEx OSCE working party member – Standard setting panel member • I have signed a – Conflict of interest declaration
  4. 4. Two distinct Fellowship Exams Written – 2 x 3 hour papers Clinical OSCE • 3 x 60 minutes over 3 days – 3 x 20 minute stations 1 day – 6 x 10 minute stations 2 days • 3 mins reading time 7 minutes exam • 4 mins reading 16 mins exam • Double stations = double marks • Select Choice Questions – 120 items – Extended matching questions – Multiple choice questions • Short Answer questions – 3 equal x 60 minute booklets – Each question contains several sub-questions, which require concise, short answer responses
  5. 5. Two Become One… • Knowledge required • Clinical experience required • Type of thinking required • You will hear the phrase ”consultant level” until a) It drives you insane b) Understand what people mean when they say it c) Have succumbed to the 3 strikes you’re out rule d) Are ready for retirement – If you discover a good definition let me know
  6. 6. Now for some practice written exam questions Grab a pen and paper!
  7. 7. ACEM FEx written SCQ – MCQ examples
  8. 8. ACEM FEx written SCQ – EMQ examples
  9. 9. ACEM FEx written SAQ example A 65 year old man presents to the emergency department with a history of palpitations. His vital signs are: BP 105/60 mmHg RR 26 /min
  10. 10. Answer the questions
  11. 11. Answer discussion • MCQ • EMQ • SAQ • How did you go?
  12. 12. Discussion on Answering • Consultant level language • Specific AND accurate • No abbreviations • Read the question • Write your best answer – Could it be better? • You can and will and many people have failed exams because of poor handwriting
  13. 13. Examples of FEEDBACK TO UNSUCCESSFUL CANDIDATES • Parts of the SAQ had no answer. • A significant number of incorrect or irrelevant answers were provided, leaving no space for the required correct answers. • The answer used vague or non-consultant level terminology. • Some of the mandatory answers were missing, meaning the answer lacked prioritisation. • The handwriting was illegible to the point it cost the candidate marks. • A response was provided or omitted which would cause significant harm to the patient, thus the zero score rule was applied to a sub question.
  14. 14. FEx Written results • Exams are standard set – Pass mark will reflect variation in difficulty between exams – Modified Angoff method – Independent judgements are made of the expected performance ‘just at standard’ candidate for each question • Standard setting determines cut score • Cut score is politically correct way of saying pass mark • “Nobody fails”
  15. 15. Recent ACEM FEx Written Results • Exam reports available on website Exam Candidates SCQ % rate SAQ % rate Overall pass rate 2015.1 271 N/A N/A 88.% 2015.2 231 N/A N/A 60% 2016.1 198 71% 76% 64% 2016.6 259 62% 64% 50% 2017.1 201 61% 55% 47%
  16. 16. FEx Clinical OSCE • Candidates assessed across multiple domains – Curriculum framework • Each station 2 - 4 domains • Scenario/tasks given outside examination room • Performance against observed and assessed by examiner
  17. 17. OSCE exam advice • The intent of the OSCE examination is to assess candidates at a level consistent with a newly graduated FACEM – Professional behaviours and interactions – Communication, psychomotor and other relevant skills – The application of medical expertise knowledge to various clinical scenarios • It is a performance based assessment – Application of knowledge • How it is applied matters… • Wear consultant shoes to the exam
  18. 18. Now for a practice OSCE realtime We are really going to do it….. I need a volunteer!
  19. 19. 2016.1B STATION 15 MANAGEMENT OF A LIFE-THREATENING LOWER GI BLEED CANDIDATE INSTRUCTIONS You are working as a consultant in a tertiary Emergency Department. The ED junior registrar (first year Advanced Trainee) seeks your advice about the management of 74 year-old Peter Smith, who presented with a large-volume PR bleed. Mr Smith has a background of atrial fibrillation and is on dabigatran. The registrar has completed the initial assessment and will provide the history, examination and relevant investigations to date. Your tasks are to: • Establish key issues from the patient’s clinical assessment. • Interpret available laboratory results. • Advise the registrar on further assessment and management of Mr Smith. You will not be required to see the patient or perform any examination. This OSCE will assess the following domains: • Medical Expertise • Communication
  20. 20. 10 minutes later…….. Take a deep breath How did that go? Tell me what you did well… Tell me blah blah blah
  21. 21. OSCE Scoring and Results • Standard setting occurs – Borderline regression method – Uses individual candidates domain scores and global score in the calculation – Single pass score for exam is created – No set number of stations required • Feedback given to unsuccessful candidates
  22. 22. Recent ACEM FEx OSCE Results
  23. 23. Domain Frequencies Increase in number to obtain more data on candidate performance See exam reports for more info
  24. 24. Fellowship exam Resources - some of my favourites • https://acem.org.au/Education-Training/Specialist-Training-Assessment- and-Exams/Fellowship-Examination.aspx • https://lifeinthefastlane.com/exams/acem-fellowship/ • http://acemfex.adelaideemergencyphysicians.com/ • http://www.shakem.co.nz/part2/overview • http://www.eduacute.com.au/simulation-blog/hitchhikers-guide-to-the- acem-fellowship-written-exam/ • https://emergencypedia.com/ • http://www.gcs16.com/ • http://www.edexam.com.au/ • There are many others
  25. 25. Final advice • Take all advice you get (including this) with a grain of salt – NO ONE is an authority on how YOU will best pass the exam • You need to study hard and be very well prepared – Follow a program • For some candidates – doing a paid course might be worthwhile – But there is a reason these courses exist • Its only an exam

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