Exam Support

When to access Exam Support

It is important for a trainee not to sit an exam if they know they have not been able to put in the necessary revision, whatever the reason(s), to give a reasonable expectation of passing.

Not all trainees will pass their postgraduate exams on their first attempt, even if they have put every effort into preparing for them. Many trainees require further assistance to help them succeed. The first step to improving the chance of gaining a pass is to recognise the need for further support.

Trainees can self-refer for support with exams at any stage.

Two consecutive unsuccessful attempts at an exam must prompt Educator discussion with the trainee about referral for Exam Support, with their consent.

Exam support from the PSWS is most useful for those who

·      Think their anxiety about exams is impacting on preparation and performance in exams at any stage of the career pathway.

·       Have failed the same exam two or more times.

·       Feel it is their technique or ability to perform the exam, rather than lack of knowledge that is the root cause.

·       Anyone who needs support refining their study skills in the context of the current job and personal circumstances

·       Anyone with known learning difficulties who fails an exam but feels they have gained the level of knowledge required.

·       Anyone that you suspect could have learning difficulties but has not been assessed.

·       Anyone for whom English is not their first language who fails an exam, but feel they have gained the level of knowledge required.

·       Anyone for whom you feel low morale is more of a factor than usual post exam failure.

An early referral is most helpful to allow the trainee to develop new strategies if required and to maximise the time available before the next attempt.

How to refer

Trainees can refer for Exam Support at any stage of the training pathway using the form available here

Educators should refer their trainees for Exam Support after 2 consecutive unsuccessful attempts, using the form available here

PSWS case managers are available for consultation prior to referal if needed on:

·     Phone  01865 932 088

·     Email PSW.tv@hee.nhs.uk

Comprehensive Exam Support services

Each referral will be offered a one hour consultation with one of our case managers to work on a collaborative understanding of the reason for accessing the PSWS. For exam support, the trainee will also be offered screening for dyslexia as part of the initial consultation.

Following this, an agreed summary of the meeting will be shared with the trainee (and Educator where relevant), and stored confidentially on the PSWS database according to IG and GDPR guidelines.

The case manager will then agree next steps with the trainee which can include signposting to services within and/or outside of PSWS.

The PSWS offers a range of services for Exam Support:

a. Vocal Coaching

b. Communications Coaching

c. Managing Exam Anxiety (at any stage of training)

d. Refining personal study skills for current context

e. Signposting to other services

In addition, should the screening threshold for dyslexia be met, we also offer:

• Dyslexia assessment

• Report with recommendations for exam mitigation

• Specialist coaching for any identified dyslexia profile

TV PSWS Exam Support Pathway here

Dyslexia – specific guidance

What is dyslexia?

A range of difficulties or learning differences, often underlie dyslexia, which is why it is often viewed as a syndrome or ‘neurodiversity’, rather than a specific condition. A useful working definition is that:

Dyslexia is a combination of abilities and difficulties that can affect reading, writing and spelling as well as organisation, memory and sequencing.

Is dyslexia considered a disability?

Around 10% of trainees are thought to have dyslexia. These trainees think differently, which can be an asset in a medical career, as they tend to think laterally in the workplace. However, by contrast, multiple choice exams under time pressure may not be their strength. People with dyslexia are often ‘big picture’ thinkers, and find making connections easier than others.

Under the terms of the The Equality Act 2010 a person is considered disabled if they have a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. Dyslexic health professionals may fall within this definition and, as such, are entitled to receive ‘reasonable adjustments’ in the educational institution and in the workplace.

The GMC also offers some guidance on support for doctors with disabilities.

Trainees with dyslexia

Trainee doctors with dyslexia may experience difficulties in completing tasks on time, especially those involving reading and writing under time pressure. A weakness in spelling, formulating written expression and processing print may affect performance. Dyslexia often overlaps with other neurodiversities such as dyspraxia and Attention Deficit Hyperactivity Disorder (ADHD).

Thames Valley PSWS dyslexia coaches

The dyslexia coaches working with the TV PSWS are:

Glynis Lavington

Jane Miller

Educator Guidance for Exam Support

There are no fixed criteria for referral to the Thames Valley PSW for exam support. There are many reasons for exam failure in both written and oral exams e.g. Viva/OSCE/CASC/CSA. A good educational supervisor should be able to support trainees following initial exam failure without the need to routinely refer to PSW for exam support. The list below might be useful as a prompt when discussing exam failure with a trainee.

·       Is exam anxiety interfering with their ability both to prepare and perform in exams?

It is well recognised that anxiety reduces the ability to focus on the task at hand, be it revision or the actual exams.

·       How have they revised?

Some may have attempted to pass the exam largely by doing MCQ-type question banks rather than learning the breadth and depth of information required or practising long essay questions. Did they have a good revision plan?  How are they learning and checking they have good recall? Ideally they should work for shorter, focussed sessions (in the order of 40 minutes) without the distractions of social media.  

·       Have they done enough work?

Trainees may fail at their first attempt because they have underestimated the amount of work involved in the preparation of a postgraduate exam. Usually 3 months of good quality revision is required as a minimum for post graduate exams

·       How have they practised their techniques and performance for oral exams?

Trainees have the knowledge but are not able to convey this in a confident and structured manner under exam conditions, which require particular strategies that are not replicated in real-time clinical scenarios. A mock exam can be a useful experience. Have they joined a peer study group to practice techniques? Have they practiced with their consultants?

·       Are there any distractions to their work?

Some may have failed because of distractions in their life outside of work that have prevented them working as they would like. As ES, it is helpful to discuss this and help consider any ongoing circumstances that need to be factored into the decision as to when to attempt a resit. Despite the pressure within training programs to pass exams within a designated time frame, it may be better to wait until the trainee can work to their full potential rather than rush into an early retake and risk low morale if they have a further failure. This should be discussed with TPD.

·       Have they failed exams at med school / earlier professional exams?

Please consider referral to the PSWS after a second consecutive unsuccessful attempt at the same exam.

·       Motivation and rebuilding confidence.

Often it may be the first time the trainee has failed anything and they may need their self-confidence rebuilding.  Your support and belief in them is important, as are any tips you can offer them. Taking a short break, giving themselves some rewards for study, talking to colleagues and creating an exam study group with peers can often be useful.

·       Any difficulty reading the questions or significant difficulty finishing within the time?

Please consider a referral to the PSWS for Exam Support

Exam support from the PSWS is most useful for those who

·      Think their anxiety about exams is impacting on preparation and performance in exams at any stage of the career pathway.

·       Have failed the same exam two or more times.

·       Feel it is their technique or ability to perform the exam, rather than lack of knowledge that is the root cause.

·       Anyone who needs support refining their study skills in the context of the current job and personal circumstances

·       Anyone with known learning difficulties who fails an exam but feels they have gained the level of knowledge required.

·       Anyone that you suspect could have learning difficulties but has not been assessed.

·       Anyone for whom English is not their first language who fails an exam, but feel they have gained the level of knowledge required.

·       Anyone for whom you feel low morale is more of a factor than usual post exam failure.

An early referral is most helpful to allow the trainee to develop new strategies if required and to maximise the time available before the next attempt.

If you would like to discuss any potential referrals please contact PSWS in the first instance. Ask to speak with one of our case managers.

Alternately please make a referral, with trainee consent, using the Educator referral form available here

Phone:  01865 932 088

Email PSW.tv@hee.nhs.uk

Trainee Guidance for Exam Support

Trainees can access support for exams at any stage of their training pathway. We have a range of dedicated coaches who provide exam support. Exam failure can occur for a wide range of reasons which we would explore with you. We recommend that you and your educator (AES) consider referral to the PSWS. Our case managers will meet with you to explore what the potential challenges might be for you. Some trainees may benefit from coaching on verbal presentation skills, others may benefit from strategies to help with coping under pressure or strategies and a small group may benefit from screening for dyslexia. The case manager will work with you to identify what approach would be most helpful.

Exam support from the PSWS is most useful for those who

Think their anxiety about exams is impacting on preparation and performance in exams at any stage of the career pathway.

Have failed the same exam two or more times.

Feel it is their technique or ability to perform the exam, rather than lack of knowledge that is the root cause.

Anyone who needs support refining their study skills in the context of the current job and personal circumstances

Anyone with known learning difficulties who fails an exam but feels they have gained the level of knowledge required.

Anyone that you suspect could have learning difficulties but has not been assessed.

Anyone for whom English is not their first language who fails an exam, but feel they have gained the level of knowledge required.

Anyone for whom you feel low morale is more of a factor than usual post exam failure.

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