(NEW) What does the future hold for assessment of psychiatry trainees?

The last few years have been a time of uncertainty and disruption, with the impact of COVID-19 and natural disasters being felt widely. These factors have had an impact on specialist training, including on assessments for psychiatry trainees. Large-scale face to face exams have been particularly disrupted, with some trainees experiencing multiple exam cancellations. Broader change within the College regarding trainee assessment has been ongoing for years, but COVID-19 has acted as a catalyst for further reassessment of this system.

Consultation is needed to decide the direction that the RANZCP assessment system should take, and these issues were discussed in a Presidential symposium with a panel of speakers chaired by Associate Professor Vinay Lakra and Dr Oliver Robertson.

Following disruptions to the November 2021 Audio-Visual Objective Structured Clinical Examination (AV-OSCE), RANZCP developed the Alternative Assessment Pathway (AAP), co-designed with a panel including trainees, Specialist International Medical Graduates (SIMG), and those involved in running the assessments. Lessons learned from the process of developing the AAP included the crucial nature of communication and having trainee/SIMG representative involvement, the importance of case based discussion examiners, and the potential new uses of technology in assessment.

The experience of developing the AAP has helped to open the College to new methods of assessment and opportunities for the future.

However, the AAP was in place as an emergency system. In the meantime, the College is planning an alternative assessment for trainees. A review of the trainee syllabus and knowledge base is taking place, including a look at the Critical Essay Question (CEQ) and Modified Essay Question (MEQ) examinations, providing opportunities to consider the assessment program going forward.

Assessment of trainees is crucial to ensure safety and high quality of psychiatric care.

Assessment is also an important way of providing feedback to trainees and SIMGs, and to provide quality assurance to the College and regulators. Going forward, the assessment program aims to make use of programmatic assessment to stimulate learning and collect meaningful data on trainee performance, embrace concepts of fairness and transparency, and foster a culture of supportive feedback.

The proposed future model of assessment includes a stage or annual progress review panel to assess trainees, aiming to provide opportunities for quality assurance while reducing the burden of assessment.

The proposed model suggests phasing out the OSCE, and the introduction of long case format or Summative Observed Clinical Assessments (SOCAs), involving the trainee taking a case history and formulating a treatment plan for a complex patient. Review of essay-style exams is ongoing, and the introduction of Multi-Source Feedback (MSF) is being considered as part of creating a feedback culture.

The aim is to create a new model of assessment for 2024. Further consultation will take place in the coming months as part of the College’s collaborative approach to refining its strategy, with ideas and contributions welcomed from College members.

Our correspondent’s highlights from the RANZCP 2022 symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

AU-HLU-0034. May 2022