British Society for Surgery of the Hand

The British Society for Surgery of the Hand (BSSH) is a leading medical organisation dedicated to advancing the practice of hand surgery globally. Founded for the public benefit to promote and direct the development of hand surgery and to co-ordinate education, study and research, the BSSH offers a Diploma in Hand Surgery in partnership with the University of Manchester. This prestigious qualification is essential for doctors wishing to pursue this surgical speciality.

The exam process for the Diploma in Hand Surgery, prior to moving online, was slow and labour-intensive. There was significant effort in producing physical exam papers, organising test centres and facilitating marking of constructed response questions by teams of hand-surgeons.

This paper-based approach required candidates to journey to a test centre to complete their written and clinical exams sequentially, leading to travel and accommodation costs, as well as more time away from work. The BSSH investigated online assessment options to see if an alternative could be found that met the security requirements for these high-stakes medical exams, but which was still cost-effective for what is a charitable organisation.

The TestReach online assessment solution was an excellent fit for the BSSH in a number of ways:

1. Cost-Effective: The TestReach solution was cost-effective as there were flexible licence options which could be adjusted in line with the number of candidates.

2. Exam Management Services: TestReach Project Managers took care of exam administration tasks, such as question upload, exam paper creation and the enrolment of candidates, lifting an administrative burden from medical personnel working at the BSSH.

3. Candidate Experience: The BSSH welcomed the opportunity to give candidates a convenient way to sit their exams from home or work. Using the live remote proctoring option provided by TestReach meant that candidates did not have to travel. Because remote proctoring from TestReach is delivered within one complete application (blocking access to browser windows, applications and external devices), and uses trained in-house proctors at a close level of supervision, it meets the high security requirements for medical exams.

4. Question Variety and Auto-Scoring: To reduce the marking burden for hand surgeons and speed up time-to-results for candidates, exams could be created in TestReach using different auto-scored question types as an alternative for previous constructed response questions.

5. Moderation: The moderation dashboards in TestReach allowed examiners to review question efficacy and to adjust scores as required, more quickly and easily than with paper-based scripts.

TestReach's capabilities have helped the BSSH to streamline exam administration, marking and moderation. TestReach project managers look after many administrative tasks when setting up the exams and BSSH examiners can access review features to check and sign off on exam papers. When moderating, examiners can review the results and question performance in TestReach, facilitating an easier adjustment to question scores if required.

Helen Hedley [MBChB, FRCS (Tr & Orth), MSc Health Sci, PGDipl Hand Surg], Consultant Hand and Wrist Surgeon at the University Hospital Coventry & Warwickshire

Helen Hedley [MBChB, FRCS (Tr & Orth), MSc Health Sci, PGDipl Hand Surg] is Consultant Hand and Wrist Surgeon at the University Hospital Coventry & Warwickshire. Helen is the most recent Director of the Diploma in Hand Surgery for the British Society of Surgery of the Hand. Commenting on the experience of moving exams online, she said:

“We used to run the exam in the morning and have consultant hand surgeons marking the papers in the afternoon, which was not a good skill-task alignment! Now we use match-list questions and MCQs in TestReach which are all auto-scored. We can see the results spread in TestReach and assess question efficacy, in addition to identifying any question anomalies. Then the team can discuss the moderation via an online meeting, saving so much time and travel for everyone involved.”

“We originally thought that using an online solution would be too expensive for the BSSH, but it has been very cost-effective. Not only does TestReach have flexible licence options, but we had a reduction in costs from printing and overnight accommodation for candidates and markers. It has also made our exams process much more environmentally friendly due to the reduction in travel.”

“Candidates are less stressed as they don’t have to travel to an unfamiliar testing centre. They can also take their exam at a separate time from their clinical Viva exam, whereas before they had to take them all in one block. Now they have their written results before the second stage.”

“We would recommend TestReach to other medical exam providers who need a very secure online solution. We seek feedback from our candidates and it’s overwhelmingly positive; they really like being able to take the exam from home and spacing out the clinical and written exams. It makes it easier to plan their studies and exams around their life. Everything we have asked for has been delivered and it has been very effective. The way the software works is intuitive and candidates like the ease of navigation and improved exam experience. There is always a very quick response if we have any queries and the support is great.”