Implementation of an Electronic Board Examination in...

UEMS Section of Medical Microbiology General Meeting Vienna, 21st April 2017

Implementation of an Electronic Board Examination in Surgery

Wolfgang Feil, MD, MAS, F.A.C.S., F.E.B.S.

President of the European Board of Surgery Professor of General & Visceral Surgery, Vienna, Austria

Medical Director, Surgical Departments, EKH, Vienna, Austria

17th European Congress of Trauma & Emergency Surgery

Vienna, 24th - 26th April 2016

Implementation of an Electronic Board Examination in Surgery

Wolfgang Feil, MD, MAS, F.A.C.S., F.E.B.S.

President of the European Board of Surgery Professor of General & Visceral Surgery, Vienna, Austria

Medical Director, Surgical Departments, EKH, Vienna, Austria

NO DISCLOSURES

Europe

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What is Europe?

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Geography Countries Culture History Religion Language Politics Economics Migration

Where people live & work

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European Union

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1957: 6 countries 2016: 28 countries

1957 2016

European Union

28 countries > 500 million inhabitants largest peacekeeping project in Europe ever

principle of "freedom of movement, labour and

services principle of "subsidiarity" principle of "mutual recognition of diploma"

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European Union

European Union Legislation

(law = a unique legal system which operates alongside the laws of member states of the E.U.)

Directives (directive = is a legislative act of the E.U. which requires member states to achieve a particular result without dictating the means of achieving that result)

Advisory Bodies

U.E.M.S. (Union of the European Medical Specialists)

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U.E.M.S. Union of the European Medical Specialists

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1958 - 6 members NGO & NPO

2015: 37 member states 28 EU countries Non-EU: Norway, Switzerland, Iceland associate member: Armenia, Israel, Turkey observer status: Georgia, Lebanon, Morocco

covers all "Medical Professional Authorities" (1.6 mio M.D.s) Medical Chambers Scientific Societies Professional Boards

website: www.uems.eu

U.E.M.S. Tasks Section, Divisions and Boards

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Promote "free movement" make labour markets more flexible & further liberalise the provision of services encourage automatic recognition of qualifications and simplify administrative

procedures

Harmonisation and standardisation of the highest level of specialist training and medical care Postgraduate specialist medical training (Syllabus, LogBook) Standards for specialist qualifications Quality Assurance in specialist medical practice CME-CPD – Continuing Medical Education and Professional Development Clinical Guidelines (not: CEN)

E.B.S.Q. (European Board of Surgery Qualifications) Examinations for "transferable competencies" Title for Qualification (Fellow of the European Board of Surgery - F.E.B.S.)

Cooperation with Scientific Societies Accreditation of training centers/institutions

U.E.M.S. main objectives

Harmonisation Standardisation Validation & Accreditation

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U.E.M.S. Tasks

Harmonisation … of what ? denominations ? contents ?

Standardisation … of what ? structures (training centers) processes quality

Validation & Accreditation … of what ? examination accreditation of training centers accreditation of trainers & examiners

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The House of Surgery

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Common Trunc/Basic Surgery

General Surgery

Vascular

General ?

Coloproct. Endocrine

Oncology Thoracic

HBP

Tx

Breast Hand Trauma

Pediatric Plastic

Orthop. Urology

OMF Neuro

Heart

ECS

Gyn ENT

The House of Surgery

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Common Trunc/Basic Surgery

General Surgery Vascular

General ?

Coloproct. Endocrine

Oncology

Thoracic

HBP

Tx

Breast Hand

Trauma

Pediatric Plastic

Orthop. Urology

OMF Neuro

Heart

ECS

Gyn ENT

General Surgery

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General Surgery: "automatic mutual recognition" in the Directive no motivation for E.U. surgeons

all other (sub)specialisations: "general system" motivation to show qualification development of multiple Divisions within the Section Surgery

harmonisation process would lead to a very low common denominator: useless definitively no motivation

Implementation of EBS Documents

European Training Requirements (General Surgery) Assessment Quality Requirements (Version 3.0)

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European Board of Surgery Fellowships in "Transferable Competencies"

General Surgery Coloproctology Endocrine Surgery Surgical Oncology Thoracic Surgery Transplantation Trauma Surgery Breast Surgery HPB Surgery

Hand Surgery Esophagus, Cardia & Stomach Surgery

(2015) Minimal Invasive Surgery (2017) Metabolic & Bariatric Surgery (2017) Emergency Surgery (2016) Endoscopy & GI-Functional

Diagnostics (2017) Basic Sciences (projected)

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Transferable Competencies

draw back from denominations omit jungle of different names for the same contents (e.g. GI-surgery and visceral surgery) omit same name for different contents

(e.g. emergency) omit harmonisation and low common denominator (=never

ending story)

switch to competencies honest logbooks from different institutions enhance rotation individualised combinations of fellowships

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European Training Requirements for all "Transferable Competencies"

Definition & Rationale of the "Transferable Competency (=TC)" Criteria for Training Institutions, Centers and Trainers Syllabus (catalogue of competencies within TC)

Theoretical Knowledge Knowledge & Skills

Curriculum (=LogBook) Intervention, Procedures, Operations (numbers!)

Eligibility Criteria for the "TC Board Fellowship" incl. CME, Mini-CEX, DOPS, courses, hospitations, publications

Board Examination

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Transferable Competencies

consider national peculiarities of contents e.g. thyroid surgery, breast cancer, endoscopy

allow variable duration of training consider national structural requirements

e.g. Finland versus Greece (geography)

allow individual programs and combinations enhance migration based on contents, competencies and

qualifications full legal acceptance and automatic mutual recognition

following the EU-principle of subsidiarity as final goal

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Transferable Competencies

robust and clearcut standardisation and validation of certain specialist qualifications

free combination of multiple TCs possible TCs also between Sections (e.g. Vasc, Thoracic) Board Fellowship is no entrance ticket into the EU enhancing migration within EU system supporting the

Maastricht criteria facilitate selection of applicants on the labour market (also

from abroad) increase employability on the labour market

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Board Examination Quality

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Eligibility Committee (Divisions) Examination Committee (Divisions) Credentials Committee (EBS/EBSQ) Preparatory Course Committee (EBS & Divisions) all report to the European Board of Surgery within the Section of Surgery

E.B.S.Q. Board Examination

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Qualification: Title "F.E.B.S." (Fellow of the European Board of Surgery)

2 step process: Eligibility & Examination "Assessment Quality Requirements" Eligibility

open for non-EU candidates CCST not mandatory structured catalogue of criteria international recommendation LogBook (with procedures & numbers) CME credits, DOCS, DOPS, mini-CEX decision: Eligibility Committee application process: ePortfolio fully

operational

Blueprint GenSurg

MCQ Test OSCE Circuit

follows Blueprint weighed 50:50 75% threshold

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GenSurg "Paper" Examination

MCQ "paper" Evaluation

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OSCE Evaluation

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Exam Evaluation

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Fellowship Ceremony

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CESMA Evaluation

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Board Examination GenSurg Belfast 2016

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Board Examination GenSurg Belfast 2016

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Vinod Kumar Singhal Vassilios Papalois

Board Examination GenSurg Belfast 2016

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Arthur Felice Mansoor Ali Khan

Board Examination GenSurg Belfast 2016

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Györgi Lazar Jonathan Tilsed

Board Examination GenSurg Belfast 2016

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Joseph Weerts

Alfonso Barbarisi

Board Examination GenSurg Belfast 2016

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Guido Gasparri Frédéric Dubas

Board Examination GenSurg Belfast 2016

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Paul Ridgway Muhammad Hanif Shiwani

Board Examination GenSurg Belfast 2016

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Paul Ridgway Muhammad Hanif Shiwani

he made it !

CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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CESMA Evaluation

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UEMS Section of Surgery 14th May 2016 Belfast

Project: "Online" Board Examination

Wolfgang Feil, MD, MAS, F.A.C.S., F.E.B.S.

President of the European Board of Surgery Professor of General & Visceral Surgery, Vienna, Austria

Medical Director, Surgical Departments, EKH, Vienna, Austria

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UEMS EBSQ Exam Database

Content MCQ & OSCE questions and answers text, PDFs, JPGs, PPT, MPEGs author & validation (gradual access rights) update information discussion & rationale & references link Blueprint category assignment TC assignment (e.g. GenSurg) monitor use & quality of question % correct answers & statistics costs (building, maintenance, per candidate)

UEMS EBSQ Board Examination

Examination "online" a/o "offline" (hardware/software)

legal aspects & safety concerns options for Examination development & service MCQ & OSCE (case studies) merge

(eliminate "jump back" in case studies)

OSCE circuit free for other requirements (e.g. scientific paper, "hands-on", simulator, interview, difficult conversation)

Why? The Board Fellowship is no "remote diploma"!

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Presentation of Systems

3 presentations (IQUL, ORZONE, SQUIZ)

mock examination at lunchtime (prepared sample questions)

decision in afternoon session (based on features and costs)

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Electronic Board Exam

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The proposal includes a basic offering at €20/candidate as well as an optional advanced offering for preparatory work, for delivery and for post processing of examination events (see attachment 1).

Additional negotiations for costs using certain "advanced options" necessary to guarantee the certified Board Examination quality

Electronic Board Exam

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Board Examination Quality

Online MCQ test regular MCQ questions (Type Apos, Aneg, Kprim, E type) include "clinical pathways" (before in OSCE) include "case studies" (before in OSCE)

OSCE circuit (oral) interview (CV) e.g. scientific paper check "soft skills" e.g. decision making processes

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European Board of Surgery Fellowships in "Transferable Competencies"

General Surgery Coloproctology Endocrine Surgery Surgical Oncology Thoracic Surgery Transplantation Trauma Surgery Breast Surgery HPB Surgery

Hand Surgery (Esophagus, Cardia & Stomach

Surgery) Oesophagogastric (2015) Emergency Surgery (2016) Minimal Invasive Surgery (2016) Metabolic & Bariatric Surgery (2017) Endoscopy & GI-Functional

Diagnostics (2017) Basic Sciences (2017)

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