1. An Alternative Certification Examination “ACE”, to assess the domains of professional practice. 
Morris M1*, Gillis AE2, Smoothey CO3, Hennessy M1, Conlon KC1, 2, Ridgway PF1, 2
 1Education Division, School of Medicine, University of Dublin, Trinity College. Dublin 2
2 Department of Surgery, University of Dublin, Trinity College, Tallaght Hospital Campus, Dublin 24
3 School of Electrical, Electronic and Mechanical Engineering, University ,Belfield, Dublin 4.
BACKGROUND
RESULTS
Metric
Value
95% Confidence Interval
Cronbachs Alpha
0.907
[0.766, 1]
Krippendorrf's Alpha
0.824
[0.824, 1]
Cohen's Kappa
0.823
[0.571,1]
Medical graduates are required to be competent in many domains of professional practice when joining the healthcare workforce 1 (Fig 1). Current undergraduate examination methods robustly assess up to five of these eight required skills. The authors previously assessed the feasibility of utilising a post graduate surgical examination format “PAME“ in an undergraduate setting with promising results 2. This study sought to further evaluate the alternative certification examination "ACE“ format in assessing all eight of the required domains of professional practice in surgical cases.
Table 1 : Inter-rater reliability between examiners
The "ACE" assessed all eight domains.
The correlation of grades between independent examiners in the "ACE" was strong at (CI 0.766, 1) Cronbachs Alpha (Table 1).
The inclusion of a patient safety measure in the pass criteria resulted in 27 (18.9%) students failing to meet the pass criteria.
The "ACE" format was reported as an acceptable examination methodology by students and examiners.
CONCLUSIONS
The “ACE” format is standardised and integrative.
The “ACE” format has strong inter-rater reliability.
The “ ACE” format assesses all eight domains of professional practice and considers patient safety in pass criteria.
The “ACE” format shows potential as an alternative to OSCE and Long Case assessment formats.
Fig 1: Domains of Professional Practice – Irish Medical Council
METHODOLOGY
143 final year medical students were contacted in February 2013.
137 students agreed to participate % of the class.
"ACE" format consisted of 4 sequential patient encounters (Fig 2)
Students were observed by two independent examiners.
“ACE” assessed all eight domains of professional practice
Examiners and students evaluated the “ACE” using a Likert scale and free text comments.
Students received structured oral and written feedback on all 4 encounters within 1 week of the examination.
REFERENCES
Irish Medical Council. Professional Competence Document Dublin. Ireland
2. Morris M, Bennett M, Hennessy M, Conlon KC, Ridgway PF. An alternative  certification examination “ACE”: Can post graduate methods be used to assess clinical skills in medical under graduates? British Journal of Medicine & Medical Research. 2013; 3 (4):
Encounter 1
Focused History- (6 minutes)
Focused Examination (6 minutes)
Encounter 2
Ordering and Interpretation of investigations results (5 minutes )
Encounter 3
Diagnosis and Management (6minutes)
Standardised Structured Oral Examination
Encounter 4
Review of case in consultation with Team (6 minutes)
Fig 2: ACE Format
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Awas gained Ethical Approval was gained from TCD Health Sciences Research Ethics Committee.