The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group.
OBJECTIVE
Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented.


METHODS
Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure.


RESULTS
The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination.


CONCLUSIONS
The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking.
University of Bern, Medical Faculty, Institute of Medical Education, Bern, Switzerland.
Christoph
C
Berendonk
University of Zurich, Medical Faculty, Zurich, Switzerland.
Christian
C
Schirlo
University of Basel, Medical Faculty, Basel, Switzerland.
Gianmarco
G
Balestra
University of Lausanne, Medical Faculty, Lausanne, Switzerland.
Raphael
R
Bonvin
University of Bern, Medical Faculty, Institute of Medical Education, Bern, Switzerland.
Sabine
S
Feller
University of Geneve, Medical Faculty, Geneve, Switzerland.
Philippe
P
Huber
University of Zurich, Medical Faculty, Zurich, Switzerland.
Ernst
E
Jünger
University of Lausanne, Medical Faculty, Lausanne, Switzerland.
Matteo
M
Monti
University of Bern, Medical Faculty, Institute of Medical Education, Bern, Switzerland.
Kai
K
Schnabel
University of Bern, Medical Faculty, Institute of Medical Education, Bern, Switzerland.
Christine
C
Beyeler
University of Bern, Medical Faculty, Institute of Medical Education, Bern, Switzerland.
Sissel
S
Guttormsen
University of Bern, Medical Faculty, Institute of Medical Education, Bern, Switzerland.
Sören
S
Huwendiek
D026683:Advisory Committees; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003479:Curriculum; D004521:Educational Measurement; D005069:Evaluation Studies as Topic; D017144:Focus Groups; D006801:Humans; D008007:Licensure, Medical / Q000331:legislation & jurisprudence*; D013557:Switzerland
OSCE; action research; licensing examination; national final examination; summative assessment