3 years on : examiners’ and candidates’ views on the CASC (Clinical Assessment of Skills and Competencies)

Aim and method: The Clinical Assessment of Skills and Competencies (CASC), introduced in June 2008 is the new and only clinical examination in obtaining membership of Royal College of Psychiatrists. Although there is evidence of strong validity and reliability for OSCE (Objective Structured Clinical Examination) - type examinations, the acceptability, validity and reliability of the CASC is open to challenge. We conducted a national online survey of candidates and examiners to obtain their views and aimed to evaluate whether the CASC fulfils its purpose. Results: The survey showed that 48% of the candidates (n=110) and 59% the examiners (n=22) agreed that the CASC examines the required competencies to progress to higher training. However only 15% of the candidates and 18% of the examiners accepted that CASC examines all the advanced psychiatric skills compared to the previous Part 2 clinical examination. Nevertheless, only a third of the candidates and examiners considered replacing the CASC with traditional long case as the best way forward. Implications: Although CASC scenarios may reflect real-life situations and its content covers most skills in piecemeal, it lacks the holistic ethos underpinning the bio-psychosocial approach unique to psychiatry. The findings of the survey suggest that the current examination method requires further systematic evaluation