Can online virtual instruction deliver success for RCPCH COVID-adapted clinical examination candidates?... We think so

ABSTRACT

BackgroundMost doctors find examinations very stressful. In order to gain membership to the Royal College of Paediatrics, paediatricians are required to sit a clinical exam. Since November 2020, candidates have had to undertake a new COVID-Adapted Clinical exam involving new examination techniques and an online platform. We noticed the change caused increased anxiety and stress amongst our fellow trainees during an already challenging time.ObjectivesTo improve exam preparedness and wellbeing for trainees in Wales sitting the COVID-Adapted Clinical examMethodsWe collaborated with the RCPCH examination team to gain insights into the new exam structure and expected standard. Prior to exam diets in November 2020 and February 2021 we provided 4–6 weeks of virtual teaching delivered via Microsoft Teams by registrars (ST4 and above) and Consultants. In November 2020, we organised the first COVID-Adapted Clinical Mock Exam in the UK using the online platform ‘Zoom.’ We wrote a range of simulated stations and utilised break out room sessions to facilitate the migration of candidates through the exam circuit. At the end of the mock exam, we gave every candidate verbal feedback in each station. Following feedback collected using an e-survey, we improved our delivery of the February 2021 Mock Exam by providing both written and verbal feedback, which was subsequently used to help inform individual coaching sessions one week prior to the exam.ResultsAll candidates (n=11) sitting the clinical exams in November 2020 and February 2021 agreed that the mock exams were ‘extremely’ or ‘very’ helpful in their preparation for the clinical exam. After the November 2020 Mock exam, candidates requested written and verbal feedback, which 2/3 of candidates sitting the February 2021 Mock stated was ‘extremely’ or ‘very’ helpful. Candidates sitting both exams said the video and communication stations were realistic and clear. Candidates said the development station was ‘similar to the real exam’ although some felt they were unclear about what the task involved. Short and extended clinical stations did receive positive feedback, with suggestions for improvement including using audio clips or images. The use of ‘Zoom’ received good feedback in spite of ‘minor technical difficulties.’ 2 candidates expressed a wish to have more time for feedback, and 2 candidates would have liked an additional clinical and history taking session. This feedback was acted upon prior to the February exam which led to a candidate mock exam satisfaction rating of 4.8/5.ConclusionsParticipation in regular online teaching and the ability to sit an online mock examination prior to the COVID-Adapted Clinical exam helped our colleagues to feel more prepared, more confident and able to gain a better understanding of what was expected of a candidate sitting the new online exam format. We will continue to use feedback to develop the teaching programme and Mock Exam to ensure all our trainees feel adequately prepared.