Practice Experience Program Specialist (PEP SP) Application Handbook

Appendix 1 - Validated assessment instruments


Appendix 1 - Validated assessment instruments


Applicants applying to the PEP SP must have completed a theoretical summative assessment in at least one of the following formats to be assessed as comparable under the PEP SP comparability assessment process.

These formats are accepted as rigorously assessing a candidate’s capacity for knowledge and clinical reasoning, which can be defined as thinking through the various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnosis, or treatment of a clinical problem in a specific patient. Patient care includes history taking, conducting a physical exam, requesting laboratory tests and diagnostic procedures, designing safe and effective treatment regimens or preventive strategies, and providing patient education and counselling.

Clinical reasoning plays a major role in a doctor’s ability to make diagnoses and decisions. It can be considered as the physician’s most critical competence.

Format Summary
Multiple Choice Questions
This style of assessment requires candidates to analyse a clinical scenario, or stem, and choose the most appropriate answer from a list of possible options.
The assessment tests clinical knowledge, requiring candidates to synthesise the information provided in the clinical stem and use only the relevant clinical components to select an answer. It demonstrates a candidate’s ability to discard irrelevant clinical components and incorrect answers, or distractors.
Extended Matching Questions
(R-type MCQs)
This is a variation on the MCQ structure but includes a series of clinical scenarios or stems rather than just a single scenario. This format allows for more in-depth assessment of clinical reasoning and problem-solving skills. Candidates are required to assess these thematically linked scenarios while discarding distractors and irrelevant clinical information to select the most appropriate answer from a common list of possible options.
The EMQ format comprises four parts for each question:
  1. A theme. This might be a symptom, investigation, diagnosis or treatment (eg back pain, dyspnoea, diabetes, corticosteroids)
  2. The clinical scenario, or stem, which outlines the scenario.
  3. The lead-in statement, which outlines what is required of the candidate (ie provide the most likely diagnosis).
  4. A possible list of answers, or options.
Single Best Answer
This format offers a single question with multiple alternative answers, from which the candidate must choose the single best answer.
Unlike other methods, the format does not offer many incorrect answers and one correct answer. Instead, it requires careful analysis of the information provided to determine which of the answers is most likely or the ‘best fit’.
Applied Knowledge Test
This assessment may incorporate elements of the above formats; it is designed to test the application of knowledge in a clinical context, rather than knowledge alone.
The questions, whether SBA or EMQ, comprise a clinical stem, a lead in statement informing the candidate of the question’s requirement, and a set of answer options.
Key Feature Problem
This assessment is designed to test clinical reasoning and clinical decision-making by assessing how candidates analyse patients in the context of a given scenario, and how they consider the key features, or critical steps, required to resolve the clinical problem.
It is not a simple short-answer assessment, instead requiring candidates to write in their own answer (when appropriate, referring back to demographic, clinical and geographic information provided in the clinical stem).
Short notes paper These papers require candidates to provide a written response in the format of short notes, bullet points, short paragraphs or essays on given topics or on a clinical scenario.


Format Summary
Clinical Examination Clinical Examination, which depending on the time of sitting, is the Objective structured Clinical Exam (OSCE), the Remote Clinical Exam (RCE) or the Clinical Competency Exam (CCE).
This exam is designed to assess how a candidate integrates their applied knowledge and clinical reasoning when presented with clinical scenarios. It tests not only knowledge and reasoning but communication skills and professional attitudes in the context of consultations, patient exams or peer discussions.
Clinical Examinations classically comprise a circuit of multiple clinical stations:
  • Shorter stations do not focus on the entire consultation, rather focusing on certain aspects of a consultation.
  • Longer stations require the candidate to manage entire consultations, including outcome of investigation and follow up visits.
Other multi-station clinical practical assessments may be equivalent to the RACGP Clinical Examination; see Academic qualifications for information on evidence required to demonstrate equivalence.

Providing additional evidence

The RACGP recognises that international specialist colleges may run assessments that differ terminologically from the above instruments, but which may, nonetheless, be equivalent or comparable in principle and structure.

Applicants who have completed assessments not named above may provide evidence as part of their application outlining why these assessments should be taken into consideration as part of their comparability assessment. This could include a letter of support from the applicant’s specialist college outlining the assessment’s requirements and structure. Colleges should provide as much information as possible, preferably including sample exam questions, psychometrics, and public reports when available.