Structured Assessment using Multiple Patient. Scenarios (StAMPS) Exam Information

Transcription

1 Structured Assessment using Multiple Patient Scenaris (StAMPS) Exam Infrmatin

2 1. Preparing fr the StAMPS assessment prcess StAMPS is an assessment mdality that is designed t test higher rder functins in a highly cntextualised framewrk where candidates have the pprtunity t explain what they d and demnstrate their clinical reasning fr a given scenari, as ppsed t simply prviding evidence f knwledge, listing facts r recalling prtcls. The methdlgy fr this assessment has been extensively researched and fund t be a high level, reliable assessment tl; StAMPS has been accepted as such by the Australian Medical Cuncil (AMC). StAMPS is essentially a hybrid between a viva vce and OSCE examinatin with the emphasis n the viva vce. Candidates are strngly advised t cnsider the relevant curriculum statements and prescribed reading list when preparing fr the assessment, as well as familiarising themselves with the frmat f this assessment mdality. The Primary Curriculum Assessment Blueprint prvides a gd guide as t which dmain areas the StAMPS examinatin will fcus n and is als f benefit fr the AST StAMPs assessments. 2. What des StAMPS assess? 1. Is the candidate a safe clinician t wrk bth independently and unsupervised in rural and/r remte primary care practice? 2. Des the candidate demnstrate apprpriate clinical reasning rather than simply demnstrating recllectin f facts? 3. Has the candidate presented their answers in the cntext f the set gegraphical and lgistical envirnment where the exam is set? Hw des it wrk? Candidates have access t a single 'Cmmunity Prfile' available n the Assessment webpage. This dcument details the setting where the examinatin is deemed t be taking place and the cntext in which the candidate is required t answer the questins. The purpse f prviding the setting f the examinatin is t ensure unifrmity fr all candidates and t ensure that candidates are able t demnstrate hw such demgraphic cnstraints may influence hw they prceed with the management f the cases presented. Fr the Emergency Medicine exam, there is an additinal supplementary prfile used fr sme f the scenaris, that assumes the candidate wrks at a larger reginal emergency department fr a cuple f weeks a year (refer t the fllwing sectin n Emergency Medicine fr further details). NB: All ther ASTs (Adult Internal Medicine, Mental Health, Paediatrics and Surgery) will nly have the single Cmmunity Prfile fr their examinatins. Number f Scenaris Each examinatin cnsists f 8 scenaris that are examined by different examiners. The scenaris cver a brad range f tpics chsen frm acrss the entire breadth and depth f the relevant curriculum and are cntextualised t ensure the seven dmains f practice are examined. 2

3 Frmat f the StAMPS exam Candidates are prvided with a 10 minute reading time prir t the start f the examinatin, when they can read the Scenari Infrmatin prvided fr each f the 8 scenaris and make ntes. Candidates are prvided with paper and pencils n the day f the exam. It is recmmended that the candidate uses the first 5 minutes f this time t cnsider the exam as a whle, then the secnd 5 minutes t fcus n the first scenari they are allcated in the examinatin. Candidates are advised t ensure they are clear abut the sequencing in which they will be presented with the eight scenaris. The individual scenaris invlve a 10 minute perid with an examiner, and have 1-4 questins r parts, and this varies each exam. The candidate is prvided with a time guide fr the parts in each scenari. The examiner will prvide prmpts where necessary t assist the candidate. Between each scenari, the candidates have 5 minutes t read the scenari infrmatin/candidate material fr the next scenari and make ntes. The candidate remains in the same rm fr the duratin f the examinatin, with the examiners mving frm rm t rm between scenaris. Each scenari is examined by the same examiner fr the duratin f the examinatin. The relevant Principal examiner (r prxy) will sit in with the regular examiners fr sme scenaris. The Primary Curriculum StAMPS examinatin is currently ffered as either a face-t-face r vide-link frmat refer t the Assessment calendar fr details. AST-Emergency Medicine and Adult Internal Medicince are currently nly ffered as a face-t-face examinatin and all ther AST examinatins nly as a virtual classrm internet link. Fr bth Primary Curriculum,AST-Emergency medicine and Adult Internal Medicine examinatin there will be eight different examiners, each respnsible fr ne scenari, fr all ther ASTs, their will usually nly be tw examiners, each delivering fur scenaris. Frmat f Scenaris Scenaris are develped frm actual clinical encunters t ensure they are very firmly based upn real life situatins. Extensive wrk is dne t ensure the different parts all have a key cncept which represents the majr area t be cnsidered in each part. The key issues are expected t elabrate upn the key cncept and are cnsistent with current clinical guidelines and best practice (eg the mst recent dcuments are guidelines frm the Heart Fundatin are used when referencing scenaris invlving Acute Crnary Syndrme r management f Rheumatic Heart Disease). Examiners are very aware f situatins where there may be differences in apprach as dictated by different State Health Department regulatins, and thus ensure n grup f candidates is disadvantaged by this factr. Prir t use, every scenari is extensively reviewed by a number f Cllege Fellws r Fellws f ther relevant Clleges (eg FACEMs in the case f the Emergency medicine examinatin). Every scenari is rad tested by either a candidate r Fellw wh has recently sat and passed the relevant examinatin t ensure wrding f the main questins, the prmpting questins and the timing f the parts f the scenari are apprpriate. Prir t the examinatin, extensive cnsideratin and cnsultatin is undertaken t identify the main issues that shuld be cvered in each part f each scenari. It shuld be nted that there is n ne perfect answer fr any given scenari and candidates d nt necessarily need t exhaustively list infrmatin as there may be a number f different perfectly reasnable appraches t answering the questins psed. Questins may start brad and then narrw in n smething specific, r start ff with a narrw fcus then braden ut. Often initial management withut a clear diagnsis is required. 3

4 The examiners are lking t ensure that Candidates are able t apprpriately cntextualise their answers and are functining at the standard expected fr a Fellw f the Cllege. The examiners have very carefully cnsidered criteria t assess candidates against. 4. StAMPS Grades and Marking Candidate perfrmance is assessed acrss five categries (belw) using a glbal assessment scale. 1. Overall Impressin 2. Develp apprpriate management plan that incrprates relevant medical & rural (cmmunity prfile) cntextual factrs 3. Define the prblem systematically 4. Cmmunicatin 5. Be flexible in respnse t new infrmatin The Glbal Assessment scale has fur categries: 1. Excellent: the examiner cnsiders that the candidate demnstrated a very high level f cmpetency. 2. Satisfactry: the examiner cnsiders that fr the curriculum and dmains cvered by the scenari that the candidate is cnsidered safe t practice independently and unsupervised in the cntext f rural and/r remte primary care practice. 3. Brderline: the examiner cnsiders that the candidate is nt yet ready t practice independently r unsupervised in this categry it may be that sme f the elements f the scenari were well cvered, but nt in thers r that the verall perfrmance was belw that expected fr a satisfactry grade. 4. Unsatisfactry: the examiner cnsiders that frm the infrmatin gathered in the scenari the candidate is nt yet safe t be practicing independently r unsupervised this grade is als awarded in the situatin where a candidate s discussin wuld result in a critical ptentially life threatening r significant mrbidity utcme fr patient presenting with a given prblem. The result f the examinatin is determined by the grades achieved acrss the eight scenaris. It shuld be nted that the standard fr the examinatin is pre-set prir t the examinatin and that there is n statistical adjustment f results. 5. Hw are the results determined? The grades awarded fr verall impressin are viewed in the first instance: If a candidate has achieved a satisfactry r higher grade in all 8 scenaris, they will have passed the examinatin. If they have achieved a brderline scre fr ne scenari, but satisfactry in the ther seven, they will have passed. In the case f nly five scenaris being at a satisfactry r higher grade, the verall result will be a fail. In thse cases where there is nt a clear result, the ther grading categries are then cnsidered, with the categry Develp apprpriate management plan that incrprates relevant medical & rural cntextual factrs being the next t be viewed and then if there is still n clear result the ther three categries are reviewed. 4

5 It shuld be nted that each grading categry is viewed individually and that the verall impressin is just that, it is nt a cmpsite scre f the ther grades awarded fr the scenari. The relevant principal examiner carefully reviews every examinatin result t ensure they are crrect. The fllwing algrithm prvided t guide grading fr Overall Impressin. Examiners fr the primary curriculum examinatin use this criteria frm the perspective f cmpetent generalist primary care prvider. Fr all the ASTs, a higher level f cmpetency is expected, but nt at the level f a specialist in the relevant area. StAMPS Algrithm Taking int cnsideratin all the key cncepts f this scenari, d yu cnsider the Candidate t be a safe Practitiner? NO YES UNSATISFACTORY GRADE *Must prvide reasns *Was there a significant deficiency? Are they perfrming at the level expected fr FELLOW f ACRRM NO YE S BORDERLINE Must cmment & prvide justificatin Are they a 'standut' exceptinal candidate NO YES SATISFACTORY EXCELLENT 5

6 Appeals, Special Cnsideratins and Incidents Please refer t the assessment handbk fr infrmatin relating t Appeals, Special Cnsideratins and Incidents. Plicies relating t these are available n the ACRRM website 6