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Helloo Friend!

Hema Here!

Give me a biggg Hi 5!

I just came across this wonderful article in our RCGP site about the ‘NEW’ CSA standard setting system!

I thought it will be very useful for you if you understand how the exam is marked and it will give you the success you need.

The ‘New’ CSA Standard – Setting System.


What and why?

Each Case.

Each day’s ‘palette’ of CSA cases is different from the next day’s and will vary slightly in difficulty. The exam must ensure that the passing standard is set fairly for each day. So after scoring a candidate’s performance on the CSA’s 3 domains, the examiner also makes a further ‘standard setting’ judgment to help set the day’s pass mark. This second grade does not affect the candidate’s score.

The CSA as a whole –all 13 Cases – A candidate’s 13 Case Scores are the basis for his or her CSA Mark. The 13 mean ‘borderline case scores’ are the basis for the ‘borderline CSA score’ which will itself be the basis for setting the pass mark for the day.

Setting the Pass Mark – It is important (for patient safety) only to pass candidates who are clearly competent. All examinations are subject to some ‘measurement error’. So, exactly as with the AKT, the initial indication of a standard is raised by an estimate of measurement error.

How your mark (as a candidate) is calculated?

Each case is graded onthree ‘domains’ –

1. Data Gathering skills

2. Clinical Management skills

3. Interpersonal skills.

To give the candidate a score on the case (‘Case Score’), each domain is graded:

Clear pass (3)    Pass (2)     Fail (1)     Clear Fail (0)

So your Case Score will be between zero and nine.

The candidate’s 13 Case Scores are added together to get their ‘CSA!Mark’. Your CSA Mark will be between zero and a maximum of 117. Note that this gives equal weight, overall, to the three domains.

Your CSA Mark is now fixed and unaffected by the calculations to set the pass mark for the day.


The pass mark

Whatever score the examiner gives (above), s/he will decide whether the performance was borderline at the level of the MRCGP.  This is not to grade you, but to help set the day’s passing standard. The system then computes the mean Case Score achieved by the borderline candidates on the case. This is the ‘borderline case score’.

The 13  mean ‘borderline case scores’ are added together to calculate an overall borderline CSA score. This will vary day- on- day because of small over all differences in difficulty of the cases. This is not affecting your mark (Case Score) as a candidate in any way. It is purely to achieve a fair pass mark for the day.

The borderline CSA score is adjusted by an agreed level calculated from the measurement error estimate (or SEm) to set the pass mark for the day.


Thats all,

To Your Success,

Hema xoxo.


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