Gersten Jonker

Variations in anesthesiology training   139 6 TABLE 3: Application of different assessment tools Assessment tool Results Number of countries (%) Direct clinical observation and feedback 33 (94) Oral examinations 31 (88) Logbook 29 (82) Multiple choice questions / exams 26 (74) Portfolio 26 (74) Objective structured clinical examination 20 (57) Essays / Paper / Assignment 18 (51) Multi source feedback 15 (42) Simulation examination 14 (40) EDAIC Part 1 examination 14 (40) Mini clinical evaluation exercise (Mini-CEX) 13 (37) Standardized patient exams 12 (34) EDAIC Part 2 examination 8 (23) Video assessment 4 (11) The number of assessment tools in group C was higher than in countries not in group C, with a mean of 9.1 (SD 2.97) tools, compared to a mean of 7.0 (SD 1.97) tools per country in other groups (p=.03). Certification processes In the majority of countries certification is ultimately granted by a governmental organization. In a few countries a university issues the certificate. The issuing bodies are advised to do so by the training institution. In some countries heads of department or program directors give this advice. Some countries have certifying committees that advise the issuing body, whereas a few other countries work with a national training body that oversees the process and advises the issuing body on granting certification. Aspects considered when advising the issuing body are: credentialing of training experience (completion of required time in training, required rotations and/or required procedures), often passing a final exam and/or approval of a piece of scholarly work, and in some cases an attestation of competence. DISCUSSION This study shows a great diversity in current assessment and certification practices in specialty training in anesthesiology in Europe. We also found that countries can be categorized according to their approach to assessment and certification (Figure 1).