nMRCGP The Applied Knowledge Test :

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nMRCGPThe Applied Knowledge Test

• Mike Cranney

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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

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Dates

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

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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)

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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

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Will test the application of knowledge

• Avoidance of unnecessary low level factual
  questions
• Blooms taxonomy
• Comprehension, application, analysis, synthesis
• Emphasis on the application of knowledge to
  real-life general practice situations

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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

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Item Formats

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

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Example of SBA Format

• Cardiac Anatomy
• The way to a mans 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

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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

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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
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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

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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

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Computer Based Testing

• It is anticipated that all candidates will
  attempt the AKT at a local invigilated test centre

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Computer Based Testing

• The test will be completed by candidates on an a
  computer screen

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Computer Based Testing

• Security at each centre will be robust
• Identity checks
• Invigilated
• Video monitoring

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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 to candidates

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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

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The AKT

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