The candidate perspective of the clinical competency test (CCT) of the MICGP examination: a mixed-methods study

Tony Foley; Kathleen McLoughlin; Elaine K Walsh; Paul Leggett; Muríosa O'Reilly; Molly Owens; Aisling A Jennings

doi:10.3399/bjgpopen18X101605

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Box 1. The seven subsections of the online questionnaire

Candidate demographics
Perception of clinical competency test attributes
Attitude toward clinical competency test environment and exam set-up
Attitude toward performance quality
Perception of educational impact
Perceived reliability and validity
General comments

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Box 2. Themes from focus groups with supporting quotes

Theme	Supporting quotes (focus group number, participant number)
Fairness and relevance of the exam	‘So yeah, I thought it was all very fair and representative of real life, yeah.' (FG1,P5) ‘It is basically examining you on a morning surgery ... ’ (FG2, P2) 'I think just working every day is good experience in itself, you know ... ' (FG1, P3) ' ... it was realistic ... and you know it was fair.' (FG1, GP2)
Exam preparation	‘You learn from people you study with too, you pick up on things, on how they consult, which is nice.’ (FG2, P3) ' ... on the day having practiced to time and having practiced the role-plays as much as possible, after the first two or three patients I felt personally the nerves went and you kind of just got in to it because you are used to doing it ... ' (FG2, P2) ' ... practicing with each other in groups is better than one to one with your trainer because they are out of training and they wouldn’t have done the exams for a few years whereas we are in the zone, so to speak ... ' (FG1, GP5)
Organisation of the exam	‘It was like clockwork it was very well run. They did a very good job ... ’ (FG2, P1) ' ... the buzzers going and everyone like a military, out and in.' (FG1, P1) ' ... really really well timed, it was really organised when I found it, like, it all ran perfectly ... ' (FG1, P5)
Examiners	'I thought they were very discreet, I barely noticed them … They were like ghosts just coming in and out and I think that just allowed us to focus on the task at hand ... ’ (FG1, P2) 'I barely noticed them ... ' (FG1, P3) '[The examiners were] totally just stone-faced' (FG2, P3)
Actors	‘You genuinely would just think that they were just patients sitting in front of you and then after two or three you just get in to that and accepted that they were who they said they were.’ (FG1, P2) 'They were really good at their role.' (FG1, P3)
Exam expense	'You can see where the money went there ... ’ (FG1, P3) 'I think it is outrageous that we don’t get fully refunded, that a good chunk of it has to come from our own pocket’ (FG1, P1)
Clinical impact	'Afterwards, even though I was nervous about the result, I felt like I was better for doing the exam ... ’ (FG2, P3) 'It’s like your driving test, isn’t it? Some habits stay, but I definitely have kept on some of it yeah.' (FG1, P2)
Feedback	'It would have been nice to see how you had performed with this. I think it would have been nice to get some feedback. Passes are very helpful but it doesn’t tell you how well you did really.' (FG1, P5) 'You know other exams that you do, you tend to bury and forget afterwards but of all the exams I have done this one, I would have loved to have known. You just get this big blank page of “pass” and that’s great and you are delighted that you passed, but you would love to know how you did in the different stations. Of all the exams we do this is literally what we are doing day to day for the rest of our lives.' (FG1, P2) 'When we got the results it would have been nice to know what your mark was and just a little comment about how you did. It should just be a bit more transparent. Like, I presume they give feedback if somebody fails it. If you work hard at something, you know, you’d like to know how you did or how you could improve ... ' (FG2, P3)

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Table 1. Candidate demographics

Variable		Frequency, n (%)
Sex	Female Male	60 (72) 23 (28)
Age, years	25 26–30 31–35 36–40 41–45 46–50	1 (1) 36 (43) 28 (34) 11 (13) 5 (6) 2 (2)
Location in which undergraduate medial training completed	Ireland UK Hungary Latvia Poland Pakistan Not specified	72 (87) 5 (6) 1 (1) 1 (1) 1 (1) 1 (1) 2 (2)
English as a first language	Yes No	78 (94) 5 (6)