Following each of its fellowship exams after results are released, the Royal Australian College of General Practitioners (RACGP) releases a report outlining the exam psychometrics (e.g., mean and standard deviation of the candidate cohort) as well as providing feedback to candidates regarding common errors made. But what has this got to do with your exam preparation, I hear you ask?
Even though the clinical exam has changed to the Clinical Competency Exam (CCE), understanding the exam requirements and common mistakes made in the past gives you the opportunity to learn from others’ mistakes and avoid making the same ones yourself.
According to the RACGP, the top mistakes made in the last few clinical Fellowship exams as documented in the exam reports were:
1. Candidates did not practice.
RACGP’s feedback in relation to previous clinical exams is that if you want to pass, you need to practice! This will be no different for the upcoming Clinical Competency Exam (CCE). The ideal way to practice is to be observed and then provided with feedback on your performance. Physically role-playing and answering potential CCE-type questions makes it easier to translate and perfect your exam performance. Paraphrasing the RACGP’s exam reports, practice exams can give an indication of whether a candidate is likely to pass or not, and they highly recommend attendance at exam preparation workshops and completion of practice exams.
2. Candidates didn’t read the instructions properly.
Similarly, as in past OSCE and RCE stations, CCE stations have individualised rating criteria that will correspond to the tasks outlined in the candidate instructions. Examiners will rate candidates on specific competencies. It is easy when stressed or anxious to skim read and/or make assumptions about what is required in a station. However, feedback from past examiners to candidates was to read the instructions carefully and understand the tasks in each case. The importance of reading carefully what is required in each station cannot be emphasised enough.
3. Candidates underperformed in key general practice competencies.
In previous clinical exams, the RACGP have reported that a number of candidates underperformed in key general practice competencies, such as those of history-taking and management. This is important to consider in the CCE as well. Underperformance in key competencies can lead to errors in the selection of initial investigations as well as formulation of provisional and differential diagnoses, likely resulting in sub-optimal rating for that station. Remember, these competencies assist you to piece together a puzzle that you are trying to decipher. The questions you ask in your history-taking can lead you down the wrong path if you don’t carefully consider what you are asking and why.
4. Candidates didn’t exhibit a ‘whole-of-patient’ approach.
Although the tasks within each case will likely be specific for each station, candidates will be expected to exhibit a ‘whole-of-patient’ approach by demonstrating core general practice skills, as found in the RACGP’s Curriculum for Australian General Practice. Familiarisation with the curriculum as well as the Domains of General Practice, will help you understand this ‘whole-of-patient’ approach and how to demonstrate it to the examiners. This is key in optimising your marks at each station.
The CCE is designed to assess how a candidate integrates their applied knowledge and clinical reasoning, when presented with a range of clinical scenarios, through demonstration of their clinical and communication skills, and professional attitudes. Hence, the use of practice exams comes “highly recommended”. So, to boost your marks or to get a higher pass rate that before, learn from other’s mistakes and follow these four tips.
5. Candidates were unprepared for the remote delivery of the exam
The CCE is designed to have at least part of the exam delivered in an online format using the Zoom platform. It is important that candidates practice using this platform with colleagues or peers to prepare themselves for the real exam. This includes the remote control function of Zoom and scrolling through information during reading time.
- The Royal Australian College of General Practitioners. RACGP Education: Exam report 2021.1 CCE. East Melbourne, Vic: RACGP, 2021.