An exploratory evaluation of the acceptability of revised physician examinations in South Africa initiated during the coronavirus disease 2019 pandemic.

BACKGROUND: This study explored the acceptability of the decentralised assessment of clinical competency (AOCC) and digital structured oral examination (SOE), introduced in South Africa (SA) during the coronavirus disease 2019 (COVID-19) pandemic, with a view to informing their potential continuation and refinement in post-pandemic contexts. METHODS: A mixed-methods study was conducted with candidates and examiners from SA training centres who participated in the AOCC and SOE in 2020-2021. Quantitative data explored perceptions regarding the credibility of the revised formats. For deeper insights, focus group discussions were held. Data were analysed using descriptive statistics and thematic analysis. RESULTS: Forty candidates completed the questionnaires with at least one representative from each SA training centre. Twelve examiners responded to the AOCC and 13 to the SOE questionnaires. Both groups viewed the revised formats broadly positively, highlighting the AOCC's fairness, relevance and acceptability. Analysis highlighted advantages such as logistical benefits, and challenges, including the need for standardisation of registrar training. The SOE was endorsed by more than 70% of participants for its standardisation, objectivity and breadth of content coverage. Both groups expressed concerns about limited examiner-candidate interaction, while candidates reported uncertainty regarding the depth of responses required. CONCLUSION: The revised formats were broadly acceptable and perceived as valid alternatives to the previous format of the examination. These findings support the continuation of hybrid, decentralised formats for future assessments. CONTRIBUTION: This study provides insight into the benefits and drawbacks of the amended Fellowship of the College of Physicians (SA) examination format, offering guidance for future reforms in medical assessment in SA and comparable resource-constrained contexts.