Siriwardena A Niroshan, Akanuwe Joseph N A, Bodgener Susan, Wilkes Bryn, Copus Stuart, Withnall Rich
Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK.
Examinations, Royal College of General Practitioners, London, UK.
Educ Prim Care. 2025 Jul;36(4):132-141. doi: 10.1080/14739879.2025.2484803. Epub 2025 Apr 17.
The Simulated Consultation Assessment (SCA) replaced the Recorded Consultation Assessment (RCA) as the summative clinical component of the Membership of the Royal College of General Practitioners (MRCGP) examination for the United Kingdom (UK) general practice licencing assessment in 2023. The SCA consists of 12 online consultations with trained role players, with candidates based in their own surgery. This study aimed to gather views of stakeholders on the new assessment before its introduction.
We conducted a cross-sectional online survey. Stakeholders completing the survey included pre-RCA and post-RCA GP trainees and educator/lay stakeholders. The survey questionnaire included Likert scaled responses and free text options. Analysis included descriptive statistics, scale development measuring positivity towards SCA, a multivariable model showing factors related to this, and qualitative assessment of free text responses.
There were 3,174 responses from 1,533 pre-RCA trainees, 920 post-RCA trainees, and 721 educator/lay stakeholders. Responders overall were positive about the design of SCA in terms of setting, validity, preparation and fairness. Multivariable analysis showed that International Medical Graduates (IMGs) were significantly more positive compared to UK graduates (B 0.19, 95% confidence interval 0.12-0.25, < 0.001) with no other differences by stakeholder group, age or ethnicity. Qualitative analysis identified four themes relating to setting requirements and contingency planning, acceptability and fairness to candidates, ability to assess consultation skills and the need for evidence for the new assessment.
Stakeholders, while positive overall, expressed suggestions relating to practice setting, the assessment's acceptability and fairness, its ability to assess consultation skills and the need for further evaluation.
模拟会诊评估（SCA）于2023年取代了记录会诊评估（RCA），成为英国皇家全科医师学院（MRCGP）考试的总结性临床部分，用于英国全科医疗执照评估。SCA包括与经过培训的角色扮演人员进行12次在线会诊，考生在自己的诊所进行。本研究旨在收集利益相关者在新评估引入前对其的看法。
我们进行了一项横断面在线调查。完成调查的利益相关者包括RCA之前和之后的全科医生培训学员以及教育工作者/外行利益相关者。调查问卷包括李克特量表回应和自由文本选项。分析包括描述性统计、衡量对SCA积极性的量表开发、显示与之相关因素的多变量模型以及对自由文本回应的定性评估。
来自1533名RCA之前的学员、920名RCA之后的学员和721名教育工作者/外行利益相关者的3174份回应。总体而言，受访者对SCA在场景设置、效度、准备和公平性方面的设计持积极态度。多变量分析表明，与英国毕业生相比，国际医学毕业生（IMGs）的积极性明显更高（B 0.19，95%置信区间0.12 - 0.25，<0.001），利益相关者群体、年龄或种族方面没有其他差异。定性分析确定了与场景设置要求和应急计划、对考生的可接受性和公平性、评估会诊技能的能力以及新评估的证据需求相关的四个主题。
利益相关者总体上持积极态度，但也提出了与实践场景设置、评估的可接受性和公平性、评估会诊技能的能力以及进一步评估需求相关的建议。
