Table 5 Possible changes to the assessment processes

· Offering restricted registration – rather than rejecting all applicants who do not meet the full criteria, a partial or limited membership (such as an academic membership) might be offered

· Adding a formal examination – relying solely on a portfolio or desktop-style assessment is ‘not objective enough in the assessment’

· Offering off-shore/internet based assessment – to address the issue of candidates needing to come to Australia the possibility of assessing candidates’ clinical skills overseas. Some options were suggested, including Australian assessors going overseas (dependant on candidate numbers) to work with overseas assessors and/or webcam-based assessment

· Dealing with borderline fail – concern was voiced over borderline fail candidates and it was suggested that there needed to be an option for borderline candidates, as identified by the examiners, to be able to ‘have some provision for perhaps, just make up the work’

· Training for candidates – the lack of candidate training and/or courses was a common issue raised by professional bodies. Suggested content for such courses included cultural competency, communication skills, knowledge of the Australian health system and or upgrading skills. Issues with training candidates included the financial cost, low candidate numbers, candidates being overseas, Australian professional development courses only being open to Australian registered practitioners and professional bodies not necessarily being educational bodies so courses would need to be outsourced

· Assessment types – changing or modifying the types of assessment utilised

· New - for some professional bodies who relied solely on desktop/portfolio there was a feeling that a skills-based assessment was also needed that might be ‘a mixture of both’ [written and clinical]

· More – a professional body who conducted both written and clinical examinations felt that this was not sufficient and was considering further assessment as they felt that there was not sufficient time to assess all they wished to

· Technology – consideration was being given to including technology-based clinical assessment (e.g., models, computer imaging) to address issues around using real patients in examinations. One body was experimenting with computerised adaptive testing in which the number and type of items presented was determined by candidate performance

· Efficiency – consideration was being given to changing the type of clinical examination from a standardised patient model to a clinical supervision model due to resource efficiency issues. Another option was to outsource the examination to educational institutions, although one professional body who did this was considering taking control back

· Assessors – some professional bodies were making changes to improve the training of their assessors including the development and use of assessor handbooks