1/
Some recent chatter about single-moment-in-time high-stakes examinations. Let’s call them #SMITHSEx for short.
Here’s why I think #SMITHSEx is dirty and should be consigned to the rubbish bin, as far as postgraduate / specialty medical training is concerned.
A thread 🧵
Some recent chatter about single-moment-in-time high-stakes examinations. Let’s call them #SMITHSEx for short.
Here’s why I think #SMITHSEx is dirty and should be consigned to the rubbish bin, as far as postgraduate / specialty medical training is concerned.
A thread 🧵
2/
Been ruminating on this for a while, and a recent #ICRE2021 thread on #SMITHSEx got my attention. @ICREConf
Been ruminating on this for a while, and a recent #ICRE2021 thread on #SMITHSEx got my attention. @ICREConf
https://twitter.com/DrNavSidhu/status/1451801776701665284?s=20
3/
A few things happened soon after. A good friend didn’t pass their #SMITHSEx, by a small margin. Meant that they couldn’t take up permanent consultant / attending post that was already offered to them, in the dept they had trained in for the past 5-7 years.
A few things happened soon after. A good friend didn’t pass their #SMITHSEx, by a small margin. Meant that they couldn’t take up permanent consultant / attending post that was already offered to them, in the dept they had trained in for the past 5-7 years.
4/
Dept obviously thought they were competent enough to offer them a post. That post is now gone and family is once again deprived of their time and care, having to sit the #SMITHSEx again.
Echoes sentiments aired by this person in a similar situation.
Dept obviously thought they were competent enough to offer them a post. That post is now gone and family is once again deprived of their time and care, having to sit the #SMITHSEx again.
Echoes sentiments aired by this person in a similar situation.
https://twitter.com/beneagle82/status/1457292494014660614?s=20
5/
He is of course referring to the @FICMNews #SMITHSEx results having only a 28% pass rate for the OSCEs, which caused a bit of a storm in UK #MedTwitter. This summarises it best:
He is of course referring to the @FICMNews #SMITHSEx results having only a 28% pass rate for the OSCEs, which caused a bit of a storm in UK #MedTwitter. This summarises it best:
https://twitter.com/TurtonsOther/status/1456668350847848451?s=20
6/
Coupled with other recent UK specialty training 'incidents' (trying to be polite), others have also rightly questioned the relevance of #SMITHSEx
Coupled with other recent UK specialty training 'incidents' (trying to be polite), others have also rightly questioned the relevance of #SMITHSEx
https://twitter.com/tivaisgreener/status/1456754672954482695?s=20
7/
Some have even suggested we change the #SMITHSEx format to reflect the fact that knowledge is now easily accessible, literally at the tips of our fingers. Regurgitation of didactic knowledge is not a reflection of our competence to practice.
Some have even suggested we change the #SMITHSEx format to reflect the fact that knowledge is now easily accessible, literally at the tips of our fingers. Regurgitation of didactic knowledge is not a reflection of our competence to practice.
https://twitter.com/OrthopodReg/status/1456975224612835332?s=20
8/
Try this thought experiment. I’ve seen many people leave training after failing #SMITHSEx. They can be split into those that were
A) clinically competent but couldn’t pass (majority)
B) obviously not suited for the role and couldn’t pass (minority)
Try this thought experiment. I’ve seen many people leave training after failing #SMITHSEx. They can be split into those that were
A) clinically competent but couldn’t pass (majority)
B) obviously not suited for the role and couldn’t pass (minority)
9/
If group A were already deemed competent by supervisors to practice independently for most things, why rely on #SMITHSEx?
And if we already knew group B were not suited for the role, why rely on #SMITHSEx?
There is of course a third group, but we won't mention them here.
If group A were already deemed competent by supervisors to practice independently for most things, why rely on #SMITHSEx?
And if we already knew group B were not suited for the role, why rely on #SMITHSEx?
There is of course a third group, but we won't mention them here.
10/
Most of us seem to be able to identify competence in trainees / residents without #SMITHSEx. Our apprenticeship-type training model allows for this.
Denmark, for example, has had no #SMITHSEx in #anaesthesia training for a long time. They rely on a suite of WBAs.
Most of us seem to be able to identify competence in trainees / residents without #SMITHSEx. Our apprenticeship-type training model allows for this.
Denmark, for example, has had no #SMITHSEx in #anaesthesia training for a long time. They rely on a suite of WBAs.
11/
I have thoughts on why the status quo can’t change, but won't air them in a public forum. Don’t need the hate.
Let’s just say it consists of, (i) institutional inertia, (ii) money, and (iii) a perceived threat to professional identity
I have thoughts on why the status quo can’t change, but won't air them in a public forum. Don’t need the hate.
Let’s just say it consists of, (i) institutional inertia, (ii) money, and (iii) a perceived threat to professional identity
https://twitter.com/mdredmond1/status/1456697291843198976?s=20
12/
In short, assessment of competency should reflect how we perform in the workplace (i.e. real life). Not how we perform in #SMITHSEx.
In short, assessment of competency should reflect how we perform in the workplace (i.e. real life). Not how we perform in #SMITHSEx.
13/end
Written exams can still exist, but they don’t have to be high-stakes. They should reflect practice in the workplace, be used as assessment FOR learning (to identify areas for improvement), and be part of a suite of tools in programmatic assessment.
Say no to #SMITHSEx
Written exams can still exist, but they don’t have to be high-stakes. They should reflect practice in the workplace, be used as assessment FOR learning (to identify areas for improvement), and be part of a suite of tools in programmatic assessment.
Say no to #SMITHSEx
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