Marking the Clinical Skills Assessment – changes for September 2010

Frequently Asked Questions

The FAQs which follow are intended to provide information for those preparing for the CSA with effect from the September 2010 examination and the changes being introduced then.

1.   How is the CSA marked?

Each case is marked by a different examiner.

2.   How many cases are marked?

There are 13 cases and each case contributes equally to the overall score.

3.   How is each case marked?

The examiner marks each case on three domains or areas - Data Gathering, Clinical Management and Interpersonal Skills. This creates an overall numerical mark for the case. Each domain carries the same number of marks.

4.   How is my final mark produced?

The marks for each case are added to create your final mark.

5.   How is the pass mark produced?

The pass mark is created using the borderline group method. As well as marking the domain scores, the examiners will also separately rate the candidate as a pass, a fail or a borderline, overall. For each case the overall numerical case marks of the candidates in the borderline group are averaged. These averaged scores are then aggregated across all the 13 cases to create the “cut score”, ie the approximation between a passing and a failing score.

The borderline group method is an established means of standard setting in clinical examinations such as OSCEs and the CSA.  It is used by a number of UK medical schools and medical Royal Colleges, and by regulators such as the GMC for the PLAB part 2 examination, and its basic form is described in Downing SM, Tekian A, Yudkowsky R.  Procedures for establishing defensible absolute passing scores on performance examinations in health professions education. Teaching and Learning in Medicine 2006; 18: 50–7

6.    Is the pass mark the same every day?

No. The borderline group method establishes the pass mark for each different daily mix of cases.

7.   What information will I be given?

You will receive electronic notification of your results, via the ePortfolio. You will get an overall score. You will be given the passing score for that day. In the unfortunate case of a fail you will receive feedback statements to guide you to appropriate areas on the web site. We hope that these will be helpful for your development before you sit the exam again.

8.   Why have these changes been introduced?

The changes are in line with suggestions made by PMETB/GMC at the time of the College’s submission of the GP speciality curriculum and assessment systems approved in late 2009.

The marks for all 13 cases on the circuit will contribute to your overall score thereby enhancing the reliability of the assessment, beyond the 12 cases used hitherto. And using the borderline group method for setting the pass mark will allow us to accommodate day to day variability in the difficulty of case mixes.