An Exploration of the feasibility of establishing a benchmark European examination in Clinical Microbiology

Abstract

Recruiting doctors in Clinical Microbiology (CM) in Ireland is challenging, and partly hindered by different training & scope of practice in CM across countries. Doctors training in CM in Ireland are required to sit a UK exam to achieve certification of specialist training. Recent changes in that exam have seen a move away from a focus on laboratory skills and Infection Prevention and Control, which are a core part of practice in CM in Ireland. The European Union of Medical Specialists (UEMS) section of Medical Microbiology (MM) created a European curriculum in MM in 2017 to further the UEMS goal of harmonisation of training and practice in Europe and established a group to create a European Exam. A pilot pan-European Exam in MM was performed in 2021 to simulate each step in the process (curriculum model, question development, blueprinting, standard-setting, reporting results). Candidates completed a questionnaire about their experience of the pilot exam (2021) (Appendix 1), while members of the UEMS section in MM completed two surveys (2019 & 2022) (Appendix 2) to assess progression towards harmonisation of training & scope of practice. Criteria to assess a pilot & feasibility study were applied, based on Thabane’s approach and some elements of the complex intervention framework. Ninety-seven candidates from 18 countries sat the 99-item MCQ exam. Rasch analysis indicated a good model fit with optimum distribution of item difficulty & candidate ability. Most candidates found the questions and language clear, and the exam difficulty appropriate, with good assessment of the curriculum. The survey of members of the UEMS section in MM shows increasing harmonisation of specialist training and scope of practice in Europe. As part of the project, a tool for guiding the development of a pilot exam was developed, to facilitate creating exams that are robust, defensible, valid and feasible.