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Abstract Title
Impact of the anaesthesia specialist examination on trainee approaches to learning

Authors:

Jennifer Weller
Marcus Henning
Andrea Thompson
Nina Civil
Brian Jolly

Institutions:

University of Auckland

University of Newcastle

Background

Assessments should support trainee development towards specialist practice, encourage learning approaches promoting deep understanding, and engender habits for effective career-long learning. We explored the extent to which the Australian and New Zealand College of Anaesthetists (ANZCA) Final Exam (FEX) met these goals.

Summary of Work

We surveyed all ANZCA advanced trainees using an established learning approaches inventory with additional questions on time spent, perceived value and how they studied for the four FEX components: MCQ, SAQ, Medical Viva, Anaesthetic viva.

more detail

Summary of Results

We received 239 responses (35%). There were significant differences between perceived value and time spent on the four components, with more time spent on less valued components. Time and relevance were not aligned with the weighting or pass rate for the individual components. Eighty per cent of trainees adopted predominantly deep learning approaches, but 20% adopted predominantly surface approaches. Written comments suggested the written ANZCA curriculum was seldom used to guide study, and different approaches were used for the four FEX components, with more superficial approaches for the MCQ, including rote learning, and deeper approaches with the SAQ.

Learning approaches from R-SPQ-2F.

N=236	Minimum score	Maximum score	Mean	SD
DA	6	36	20.18	5.69
SA	0	34	10.82	6.49

DA = Deep approach, SA= Surface approach. Maximum score for DA and SA is 50.

Perceived value and time spent on the different exam components

Perceived Value (%)	Mean	MCQ 41.84	SAQ 61.86	Medical Viva 59.22	Anaesthetic viva 93.96
Perceived Value (%)	SD	27.48	23.68	26.94	14.70
Time spent (%) (n = 236)	Mean	33.18	24.18	12.28	30.35
Time spent (%) (n = 236)	SD	13.47	10.39	5.56	10.45

more detail

Conclusion

The FEX was generally seen as relevant, encouraging deep learning approaches but this varied between components. This contrasts with reports suggesting learning approaches become more surface through undergraduate programs. Participants rarely used the written curriculum for learning.

Take-home Messages

A high stakes exam in specialist training drives knowledge acquisition but the curriculum can become, by default, previous test items. Some assessment methods encourage deeper approaches and likely to promote skills for life-long learning.

References

1. Epstein RM. Assessment in medical education.[see comment]. New England Journal of Medicine. [Review]. 2007 Jan 25;356(4):387-96.

2. Biggs J, Kember D, Leung DYP. The revised two-factor Study Process Questionnaire: R-SPQ-2F. British Journal of Educational Psychology. 2001 71(1):133-49.

3. Baruch Y. Response rate in academic studies - a comparative analysis. Human Relations. 1999;52(421-428).

Acknowledgement

This project was supported by a grant from the Australian and New Zealand College of Anaesthetists.

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Summary of Work

Modified Biggs revised Study Process Questionnaire

1. I find that at times studying gives me a feeling of deep personal satisfaction.

2. I find that I have to do enough work on a topic so that I can form my own conclusions before I am satisfied.

3. My aim is to pass the exam while doing as little work as possible.

4. I only study seriously what's given out in class or in the course outlines? what’s likely to be in the exam

5. I feel that virtually any topic can be highly interesting once I get into it.

6. I find most areas of the curriculum interesting and often spend extra time trying to obtain more information about them.

7. I do not find the curriculum very interesting so I keep my work to the minimum.

8. I learn some things by rote, going over and over them until I know them by heart even if I do not understand them.

9. I find that studying anaesthesia-related topics can at times be as exciting as a good novel or movie.

10. I test myself on important topics until I understand them completely.

11. I find I can get by in most assessments by memorising key sections rather than trying to understand them.

12. I generally restrict my study to what is specifically required as I think it is unnecessary to do anything extra.

13. I work hard at my studies because I find the material interesting.

14. I spend a lot of my free time finding out more about interesting topics which have been discussed in theatre or in tutorials.

15. I find it is not helpful to study topics in depth. It confuses and wastes time, when all you need is a passing acquaintance with topics.

16. I believe that supervisors shouldn't expect students to spend significant amounts of time studying material everyone knows won't be examined.

17. I come to most tutorials or supervised theatre sessions with questions in mind that I want answering.

18. I make a point of looking at most of the suggested readings that go with the lectures.

19. I see no point in learning material which is not likely to be in the examination.

20. I find the best way to pass examinations is to try to remember answers to likely questions.

Summary of Results

Written Responses

Grouped responses	MCQ	SAQ	Med Viva	Anaes Viva
EXAM PRACTICE
Undertaking practice in the exam format	224	187	201	214
Practice under examination conditions	8	82	19	17
GENERAL READING
Reading	106	85	119	70
General topic-based reading	77	0	29	17
Reading around gaps found by exam practice	48	0	0	16
STUDY GROUP
Using a study group	90	53	103	42
CURRICULUM
Using published exams to guide learning	224	83	15	32
Using ANZCA syllabus to guide learning	0	9	0	0
Using clinical practice to guide learning	0	14	0	7
SURFACE APPROACHES
Learning from other candidates’ answers	59	18	0	5
Memorising / rote learning	45	1	3	4