Candidate perceptions of the UK Recorded Consultation Assessment: cross-sectional data linkage study

ABSTRACT

The Recorded Consultation Assessment (RCA) was rapidly developed to replace the Clinical Skills Assessment (CSA) for UK general practice licencing during COVID-19. We aimed to evaluate candidate perceptions of the RCA and relationships with performance. We conducted a cross-sectional survey of RCA candidates with attitudinal, demographic, and free text response options, undertaking descriptive and factor analysis of quantitative data with qualitative thematic analysis of free text. Binomial regression was used to estimate associations between RCA pass, candidate characteristics and questionnaire responses.

645 of 1551 (41.6%) candidates completed a questionnaire; 364 (56.4%) responders permitted linkage with performance and demographic data. Responders and non-responders were similar in exam performance, gender and declared disability but were significantly more likely to be UK graduates (UKG) or white compared with international medical (IMG) or ethnic minority graduates. Responders were positive about the digital platform and support resources. A small overall majority regarded the RCA as a fair assessment; a larger majority reported difficulty collecting, selecting, and submitting cases or felt rushed during recording.

Logistic regression showed that ethnicity (white vs minority ethnic: odds ratio [OR] 2.99,95% confidence interval [CI] 1.23, 7.30, p = 0.016), training (UK vs IMG: OR 6.88, 95% CI 2.79, 16.95, p < 0.001), and English as first language (OR 5.11, 0% CI 2.08, 12.56, p < 0.001) were associated with exam success but questionnaire subscales, consultation type submitted, or extent of trainer review were not. The RCA was broadly acceptable but experiences were variable. Candidates experienced challenges and suggested areas for improvement.

KEYWORDS:

• Education
• medical
• postgraduate
• assessment
• licencing
• general practice
• Covid-19

Acknowledgments

We are grateful to the MRCGP examinations department for supplying anonymised data. Our thanks to members of the Community and Health Research Unit for comments on the paper.

Contributions

All authors contributed to the conception and design of the study, revision, and final approval of the paper. All authors agree to be accountable for all aspects of the accuracy and integrity of the study.

Disclosure statement

PC, AF, MD, and ANS have received funding from and are members of the panel of MRCGP examiners. RW is psychometrician to the RCA and has received funding from the RGCP in this role. DL, VP, VB and GL have declared no competing interests.

Ethical approval

Ethical approval was granted by the Research Ethics Committee of the University of Lincoln.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

Royal College of General Practitioners, UK.