Is the MRCPsych fit for purpose?
| Date | 11 September 2017 |
| Pages | 331-336 |
| DOI | https://doi.org/10.1108/JMHTEP-07-2016-0036 |
| Published date | 11 September 2017 |
| Author | Lance Vincent Watkins |
| Subject Matter | Health & social care,Mental health,Mental health education |
Is the MRCPsych fit for purpose?
Lance Vincent Watkins
Abstract
Purpose –The purpose of this paper is to examine whether the current Royal College of Psychiatrists
Membership (MRCPsych) written examination is a suitable assessment tool to distinguish between
candidates in a high-stakes examination.
Design/methodology/approach –Review of current educational theory and evidence in relation to the use
of multiple-choice questions (MCQs) as an assessment form.
Findings –When MCQ’s are constructed correctly they provide an efficient and objective assessment tool.
However, when developing assessment tools for high-stakes scenarios, it is important that MCQs areused
alongside other tests that may scrutinize other aspects of competence. It may be argued that written
assessment can only satisfy the first stage of Miller’s pyramid. The evidence outlined demonstrates that this
may not be the case and higher order thinking and problem solving can be assessed with appropriately
constructed questions. MCQs or any other singular assessment alone, cannot demonstrate clinical
competence or mastery.
Originality/value –Increasingly, the MRCPsych examination is used around the world to establish levels of
competency and expertise in psychiatry. It is therefore essential that the Royal College of Psychiatrists lead
the way in innovation of assessment procedures which are linked to current educational theory. The author
has evidenced how the current MRCPsych, may at least in part, hold inherent biases which are not related to
a candidate’s competency.
Keywords Psychiatry, Education, Examination, Assessment, MCQ, MRCPsych
Paper type General review
I am currently a higher trainee in Psychiatry of Intellectual Disability. Therefore, I have recent
experience of the Royal College of Psychiatrists Membership (MRCPsych) examinations and the
onerous effort involved. There is an anecdotal consensus that the MRCPsych written
examinations are an arduous undertaking, as membership examinations should be. However,
there is also an impression that the MRCPsych written examinations are inherently the last step in
a series of hoops before entering higher training. In order to succeed in these examinations one
must gain mastery in answering the multiple-choice question (MCQ), rather than expertise in
psychiatry. Therefore, is the MRCPsych fit for purpose, or do the Royal College of Psychiatrists
(RCPsych) need to look to lead the way in the development of a new assessment tool aligned
with current educational theory?
In the UK, trainee psychiatrists are required to pass the MRCPsych in order to progress to higher
training, and achieve a Certificate of Completion of Training. The MRCPsych forms the main
summative assessment in postgraduate psychiatric training and may therefore be considered a
high-stakes examination. In high-stakes testing, it is important that the assessment tool
distinguishes between pass and fail with reliability and validity. The MRCPsych itself comprises of
two broad components, written examinations and a clinical examination. This discussion will
specifically critique the use of MCQs within the written examinations, which comprise the majority
of marks available (2/3). This discussion will not consider in detail the minority of the examination
(1/3) made up of extended match items (EMIs). Unfortunately, there is no data specific to the
MRCPsych examination MCQs readily available for analysis. We will therefore draw on evidence
from elsewhere in the medical education literature. The utility of an assessment includes
consideration of the tools reliability, validity, educational impact, acceptability, feasibility and cost
effectiveness (Van Der Vleuten, 1996).
Received 20 July 2016
Revised 29 November 2016
15 March 2017
Accepted 24 March 2017
Lance Vincent Watkins is a
Specialist Registrar at Learning
Disability Directorate,
Cardiff, UK.
DOI 10.1108/JMHTEP-07-2016-0036 VOL. 12 NO. 5 2017, pp. 331-336, © Emerald Publishing Limited, ISSN 1755-6228
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
j
PAGE331
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