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n MRCGP The Applied Knowledge Test :

n MRCGP The Applied Knowledge Test :. Prepared by Bill Irish On behalf of the nMRCGP AKT core group. Health Warning. Contemporary as of April 2007. The AKT:.

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n MRCGP The Applied Knowledge Test :

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  1. nMRCGPThe Applied Knowledge Test : Prepared by Bill Irish On behalf of the nMRCGP AKT core group

  2. Health Warning Contemporary as of April 2007

  3. The AKT: • The Applied Knowledge Test (AKT) is a summative assessment of the knowledge base that underpins independent general practice within the United Kingdom. • Candidates who pass this assessment will have demonstrated their competence in applying knowledge at a level which is sufficiently high for independent practice.

  4. Format: • An “evolution” from the current MRCGP MCP • A three hour, 200 item multiple-choice test • Delivered on a computer terminal at an invigilated test centre • Offered initially three times a year • Will be also used for GMC performance assessments in general practice

  5. Dates • First sitting: • October 2007 • Papers will be offered three times a year: • October/November • February • April/May

  6. Rules • No limit to the number of attempts • A pass will be valid for three years only • Can be attempted at any time during GP specialist training (GPST), but most appropriately during the GPR year (ST3)

  7. Transitional Arrangements • Will replace the Summative Assessment MCQ from August 2007 • Is deemed to be equivalent to the current MRCGP MCP for those completing the current exam during 2007-8

  8. Will test the application of knowledge • Avoidance of unnecessary “low level” factual questions • Bloom’s taxonomy: • Comprehension, application, analysis, synthesis • Emphasis on the application of knowledge to real-life general practice situations

  9. Breakdown by subject • Core clinical medicine and its application to problem solving in a general practice context: • 80% of items • Critical appraisal and evidence based clinical practice • 10% of items • Health informatics and the organisational structures that support UK general practice • 10% of items

  10. Cardiovascular Dermatology Endocrinology ENT Gastroenterology Genetics Haematology Immunology Infection Mental health & learning disability Musculo-skeletal Neurology Ophthalmology Paediatrics Renal Reproductive male/female Respiratory Therapeutic indications and adverse reactions Clinical Medicine

  11. Sources of reference • Definitive medical resources including: • British National Formulary • Clinical Evidence • Cochrane • National guidance applying to all four home countries

  12. Critical Appraisal and EBM • Interpretation of research data • Critical appraisal • Familiarity with basic terms and concepts

  13. Administrative • Legal knowledge • Driving test regulations etc • Health and safety • Certification • Prescribing • Etc…

  14. Item Formats • Single Best Answer (SBA) • Extended Matching (EMQ) • Tables and Algorithms (for completion) • Photographs

  15. Example of SBA Format Cardiac Anatomy The way to a man’s heart is : - Which is the SINGLE MOST likely answer? Select ONE option only A Through his aorta B Down the M6 and off at junction 4 C Through his pulmonary arteries D Through his pulmonary veins E Through his stomach

  16. Example of EMQ Format Food and Drink A Asti Spumante G Chilled Vodka B Australian Shiraz H Gevrey Chambertin C Barolo I Mexican Beer D Ceylon Tea J Oloroso Sherry E Chablis Premier Cru K Sauternes F Chianti L Sauvignon Blanc For each food listed below, select the SINGLE most appropriate drink. Each drink may be used once, more than once, or not at all 1 Coq au vin 5 Nuts 2 Crème brûlée 6 Oysters 3 Gumbo 7 Snapper 4 Kipper 8 Wild duck

  17. Not requiring contraception Requiring contraception 3 _______ 1 _______ 2 _______ Combined oral contraceptive pill Example of Table/Algorithm Format The Medical Management of Menorrhagia For each of the numbered gaps above, select ONE option from the list below to complete the algorithm, based on current evidence. Each option may be used once, more than once or not at all. Medroxyprogesterone acetate Mefenamic acid Nonoxinol ‘9’ Tibolone Tranexamic acid A. Cyclical norethisterone B. Copper-bearing intra-uterine device C. Inert intra-uterine device D. Levonorgestrol releasing intra-uterine system

  18. Example of Image Format Eye problems A 42 year old woman who has previously had treatment for cervical CIN 2 has had a lump affecting her left upper lid for three months. It is asymptomatic What is the single most likely diagnosis in this patient? Select one answer only Entropion Meibomian cyst Metastatic deposit Stye Xanthelasma

  19. Feedback • Individual feedback will be provided to every candidate • Their overall score • The pass mark • Their performance in each of the 3 main subject area • More general feedback on overall performance issues will continue to be forwarded to all UK deaneries and placed on the RCGP website

  20. Reliability • Items will have been piloted in the current MRCGP MCP which provides high reliability coefficients of up to 0.92 on a similar test • We anticipate similar results on the AKT, although the cohort of doctors will be somewhat different to that currently attempting the MRCGP MCP

  21. Validity • Item writers • All practising GPs • Writers also hold deanery, academic, PCT and teaching commitments • Peer reviewed, with lay and psychometric representatives • Internationally standard item formats • Blueprinted against national RCGP curriculum • Formal validity studies will be necessary in the future

  22. EqualOpportunities • Will adhere to current best practice with relation to the avoidance of discrimination • Will comply with all relevant UK legislation

  23. Standard Setting • Will be criterion referenced • In accordance with internationally accepted best practice • Methods will utilise both subject experts and lay representatives

  24. Computer Based Testing • It is anticipated that all candidates will attempt the AKT at a local invigilated test centre

  25. Computer Based Testing • The test will be completed by candidates on an a computer screen

  26. Computer Based Testing • Security at each centre will be robust • Identity checks • Invigilated • Video monitoring

  27. Computer Based Testing • Test forms are downloaded to each centre each day • Separate quarantined morning and afternoon sittings • Responses will be uploaded to a central server and then passed to the RCGP for post test analysis • Following this, results and feedback will be sent individually tocandidates

  28. Computer Based Testing • There are approximately 150 test centres covering all parts of the UK • Candidates will be able to book the AKT at a local venue, on “a first come, first served” basis

  29. The AKT • Work in progress • We will keep educationalists and candidates fully informed of developments • Watch this space!

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