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    (Original post by gozatron)
    Agreed but there has still got to be some sort of assessment to proove the teaching is allowing you to gain this knowledge. Correct me if i'm wrong but i'd feel a series of synoptic smaller exams/assessments would be more beneficial to ensuring knowledge is retained than one big lump exam, clinically and pre-clinically.
    I think there is a need to test, of course, but there's enough crammed into the medical degree as it is (sadly at the expense of being able to learn much in detail, in most curriculums), to make space for more frequent assessment. And there is a need to check that you know everything you should know - after all, your patient is not going to present with only the thing you learned most recently.

    I guess my beef with any form of nationalised testing, whether that be progress testing or any other exam, is that regardless of whether you can teach to it or not, it will influence curriculum design, and it will always be inherently biased towards certain schools - is this not why there is as yet no agreed exam, because certain schools are pushing for in depth science and others are pushing for communication skills, etc, all at the greatest benefit to their own students?
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    (Original post by gozatron)
    Agreed but there has still got to be some sort of assessment to proove the teaching is allowing you to gain this knowledge. Correct me if i'm wrong but i'd feel a series of synoptic smaller exams/assessments would be more beneficial to ensuring knowledge is retained than one big lump exam, clinically and pre-clinically.
    True, but what material would you use for the clinical regular knowledge examinations?

    However, using finals material for first years isn't shown to be very reliable.

    (Original post by Becca-Sarah)
    I think there is a need to test, of course, but there's enough crammed into the medical degree as it is (sadly at the expense of being able to learn much in detail, in most curriculums), to make space for more frequent assessment. And there is a need to check that you know everything you should know - after all, your patient is not going to present with only the thing you learned most recently.

    I guess my beef with any form of nationalised testing, whether that be progress testing or any other exam, is that regardless of whether you can teach to it or not, it will influence curriculum design, and it will always be inherently biased towards certain schools - is this not why there is as yet no agreed exam, because certain schools are pushing for in depth science and others are pushing for communication skills, etc, all at the greatest benefit to their own students?

    That is the exact reason for the lack of a national exam. However what would be so wrong with in-house multiple exams at finals level? For students in clinical years?

    Surely repeated testing of the final outcome expected would be beneficial?
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    (Original post by carcinoma)
    True, but what material would you use for the clinical regular knowledge examinations?

    However, using finals material for first years isn't shown to be very reliable.

    That is the exact reason for the lack of a national exam. However what would be so wrong with in-house multiple exams at finals level? For students in clinical years?

    Surely repeated testing of the final outcome expected would be beneficial?
    I fail to see how repeated testing of the same material (which I presume the progress test to be, else how would it show progress over time?) shows anything except how many questions a student can memorise from previous papers? Surely repeated testing of finals material just massages the results? To my mind, testing should be appropriate to the level of teaching - I can't see the point in presenting students with questions that they haven't the expertise to answer. Else why not just replace finals with questions taken from the MRCP/S/GP and see how students perform? We have finals mocks in December and the real thing in June of fourth year, with an OSCE in fifth year, and to me that seems an appropriate amount of testing without continually eroding practical learning time. At clinical level, you're being tested every day on the wards, in a much more realistic setting than an exam hall - in real life you can't go "I'll think of the answer in a minute, I'll just leave that patient and come back to it later".
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    (Original post by Becca-Sarah)
    I fail to see how repeated testing of the same material (which I presume the progress test to be, else how would it show progress over time?) shows anything except how many questions a student can memorise from previous papers? Surely repeated testing of finals material just massages the results? To my mind, testing should be appropriate to the level of teaching - I can't see the point in presenting students with questions that they haven't the expertise to answer. Else why not just replace finals with questions taken from the MRCP/S/GP and see how students perform? We have finals mocks in December and the real thing in June of fourth year, with an OSCE in fifth year, and to me that seems an appropriate amount of testing without continually eroding practical learning time. At clinical level, you're being tested every day on the wards, in a much more realistic setting than an exam hall - in real life you can't go "I'll think of the answer in a minute, I'll just leave that patient and come back to it later".
    I am not suggesting using the exact same material, I am suggesting the use of 80% of clinical medicine (the level needed for FY1s) with 20% Basic sciences material. This would be a vast array of different questions.

    It would be far too hard to prepare for that kind of test. It realistically would not erode practical learning time as an exam would only be about 3 hours long and delivered every 8 weeks. It would in principle, sample at regular intervals from the complete domain of knowledge considered a requirement for medical students on completion of the undergraduate programme
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    (Original post by Becca-Sarah)
    I fail to see how repeated testing of the same material (which I presume the progress test to be, else how would it show progress over time?) shows anything except how many questions a student can memorise from previous papers? Surely repeated testing of finals material just massages the results? To my mind, testing should be appropriate to the level of teaching - I can't see the point in presenting students with questions that they haven't the expertise to answer. Else why not just replace finals with questions taken from the MRCP/S/GP and see how students perform? We have finals mocks in December and the real thing in June of fourth year, with an OSCE in fifth year, and to me that seems an appropriate amount of testing without continually eroding practical learning time. At clinical level, you're being tested every day on the wards, in a much more realistic setting than an exam hall - in real life you can't go "I'll think of the answer in a minute, I'll just leave that patient and come back to it later".
    Actually providing that questions from MRCP/S/GP are delivered in equal proportions, numerous times each year, and that the passmark expected from a 5th year in their final exam is lowered to an appropriate level (e.g 40%), I cant see how this would be a bad thing.

    But the problem with that is that the material is what is expected of doctors in speciality training. If you replace the material with what is required for a doctor in their first year of the foundation programme you have an exam with content at the appropriate level and a reliable testing method, as required by Tomorrows Doctors.
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    (Original post by carcinoma)
    I am not suggesting using the exact same material, I am suggesting the use of 80% of clinical medicine (the level needed for FY1s) with 20% Basic sciences material. This would be a vast array of different questions.

    It would be far too hard to prepare for that kind of test. It realistically would not erode practical learning time as an exam would only be about 3 hours long and delivered every 8 weeks. It would in principle, sample at regular intervals from the complete domain of knowledge considered a requirement for medical students on completion of the undergraduate programme
    You're not addressing a lot of my points though. What is the point in testing students at a level above that required at that stage of their training? Why is continual assessment even needed? Surely practical assessment of knowledge on a daily basis (i.e. ward round questions, 'does this student know what they're talking about re this patient's diagnosis, management, etc?' and so on) is far more appropriate than exams every 8 weeks? I'd be fairly fed up if I had to sit a 3hr exam every 8 weeks! Exam stress is quite sufficient without making it any more frequent!
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    (Original post by carcinoma)
    x
    Apologies, we seem to be cross-posting, so I missed your subsequent comments.

    How demoralising is that, to be 'passing' an exam when you get 60% of the questions wrong?! Medical school is supposed to encourage, not beat down, its students.
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    (Original post by Becca-Sarah)
    You're not addressing a lot of my points though. What is the point in testing students at a level above that required at that stage of their training? Why is continual assessment even needed? Surely practical assessment of knowledge on a daily basis (i.e. ward round questions, 'does this student know what they're talking about re this patient's diagnosis, management, etc?' and so on) is far more appropriate than exams every 8 weeks? I'd be fairly fed up if I had to sit a 3hr exam every 8 weeks! Exam stress is quite sufficient without making it any more frequent!
    Apologies for not addressing all your points. Ill try to do that now, assessment at the stage of students training allows cramming as the students know what material they will be tested on. It does not encourage continuous learning, if you can just learn for the exams in a "revision/cramming" period, this would allow people to pass exams without developing knowledge regularly.

    Continuous assessment removes the stress of exams as they are so frequent and based on material which cannot be prepared for in the earlier stages of the course, and due to the vast array of question areas even in later stages it requires continuous knowledge acquisition rather than revision/last minute cramming.

    Of course practical knowledge assessment would be the ideal, however, that kind of on the spot assessment can only assess a relatively small volume of knowledge, so that would be an inappropriate method of testing medical knowledge as a whole.

    OK well every 10 weeks rather than 8 weeks (4 times each year), personally i find it less stressful around exam periods due to the frequency and low expectation. I'm only expected to be achieving ~25%.
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    Whilst we're on the topic of exams, what do people think of not disclosing marks and scores and simply having a pass or fail system? Obviously marks and the like are collected for foundation post ranking purposes and analysing the examination system etc., but they are not published for students. The students are just told if they passed or failed (or any borderline-type marks that some schools give out).

    I feel like it might reduce some of the petty competition that seems rife amongst medical students and facilitate students learning from each other.
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    (Original post by carcinoma)
    Anastomosis (with some angiogenesis)
    No that's not it :nah:

    There is a specific term for it that only means that one specific thing. And it's not angiogenesis - the arteries are already there, they just open up more to accommodate more blood to become the major artery in the limb.


    (Original post by Kinkerz)
    Very much, just paper-based rather than web-based.
    See our "logbook" is a written up patient history/examination findings for proforma A, and then the proforma B is the background of the disease (aetiology, presentation, investigations management etc) and we have minimum of 11 to do each module :sadnod:
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    (Original post by Kinkerz)
    Whilst we're on the topic of exams, what do people think of not disclosing marks and scores and simply having a pass or fail system? Obviously marks and the like are collected for foundation post ranking purposes and analysing the examination system etc., but they are not published for students. The students are just told if they passed or failed (or any borderline-type marks that some schools give out).

    I feel like it might reduce some of the petty competition that seems rife amongst medical students and facilitate students learning from each other.
    That's how it's being done at my uni now for year 1s and 2s. Our year was the last cohort to go through the grade system for exams (A-distinction, B-merit etc etc E-fail). I agree that it did make people super competitive, but i wouldn't say it's a bad thing. Those who worked harder than others were suitably rewarded with a higher grade, so its only fair.
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    (Original post by Isometrix)
    That's how it's being done at my uni now for year 1s and 2s. Our year was the last cohort to go through the grade system for exams (A-distinction, B-merit etc etc E-fail). I agree that it did make people super competitive, but i wouldn't say it's a bad thing. Those who worked harder than others were suitably rewarded with a higher grade, so its only fair.
    In principle I agree with you, but I've experienced idiotic things like people being reluctant to disclose a resource they got a certain piece of information from or not contributing in PBL so as to avoid disseminating their work.
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    (Original post by Kinkerz)
    In principle I agree with you, but I've experienced idiotic things like people being reluctant to disclose a resource they got a certain piece of information from or not contributing in PBL so as to avoid disseminating their work.
    :no: that's just sad

    Having said all that before, I would totally advocate a pass-fail system because I was never one of those who got the high grades anyway
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    Anyone see this? Absolutely abhorrent stuff. Foundation trusts that are in huge financial trouble with little else to turn to are surely going to take on way, way more private patients in order to bridge the financial gap, putting NHS patients in the back burner. It's absolutely sickening and a belligerent attack on the founding principles of the NHS.
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    (Original post by Woody.)
    It's absolutely sickening and a belligerent attack on the founding principles of the NHS.
    Or a way to potentially save it.

    I'm divided on the issue, but this is more complicated than you're making it out to be.
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    (Original post by Kinkerz)
    Or a way to potentially save it.

    I'm divided on the issue, but this is more complicated than you're making it out to be.
    Yeah, I agree with Kinkers.

    My gut instinct tells me that 49% is too high. 2% is a joke though. I'm more against the 2% than I am the 49%. Given the option of only those two I'd lean towards the 49%.

    I think somewhere the middle would gain the best of both worlds though.

    The waiting times for those with large financial deficits are already going to be **** anyway.

    I also don't quite understand the quote from Dr Peter Carter, "This will undoubtedly lead to a situation whereby those who can afford to pay will get faster access to better treatment, with increased waiting times and a decrease in quality for NHS patients." Well no **** Sherlock. That's how it works anyway.

    Private is only available for certain treatments anyway, it's not like you're going to get a kidney/treatment for an MI quicker if you're willing to pay for it, legally anyway.
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    (Original post by Kinkerz)
    Or a way to potentially save it.

    I'm divided on the issue, but this is more complicated than you're making it out to be.
    It's a pretty big step up. Why not increase it to 10 % or 20 %? A move to allow trusts to hit a maximum of almost half seems dodge viper if you catch my drift.
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    (Original post by xXxBaby-BooxXx)
    No that's not it :nah:

    There is a specific term for it that only means that one specific thing. And it's not angiogenesis - the arteries are already there, they just open up more to accommodate more blood to become the major artery in the limb.
    In that case arteriogenesis is the formation of arteries from existing vessels.
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    (Original post by Kinkerz)
    Whilst we're on the topic of exams, what do people think of not disclosing marks and scores and simply having a pass or fail system? Obviously marks and the like are collected for foundation post ranking purposes and analysing the examination system etc., but they are not published for students. The students are just told if they passed or failed (or any borderline-type marks that some schools give out).

    I feel like it might reduce some of the petty competition that seems rife amongst medical students and facilitate students learning from each other.
    In terms if which examinations? Except for our professionalism module the rest of our exams are pass/fail but we are given a mark as well.
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    (Original post by Kinkerz)
    In principle I agree with you, but I've experienced idiotic things like people being reluctant to disclose a resource they got a certain piece of information from or not contributing in PBL so as to avoid disseminating their work.
    I have begun to notice this as well.

    The entire point of PBL would be to share your knowledge within the group, teach your peers to enhance your collective knowledge. Why some people who have clearly done the learning and been to all the same sessions we have been to are reluctant to speak up even though we all know the stuff.
 
 
 
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