The challenge
Following the rapid move from face-to-face to online assessment during the pandemic, a professional body faced a bigger question than whether its examinations should stay online.
New curricula were being introduced. Candidate numbers and international demand had grown. Expectations around accessibility and candidate experience were changing. And the organisation needed to be confident that its assessments continued to test the right knowledge, skills and behaviours in a way that was valid, reliable, fair and sustainable.
Rather than simply choosing between digital and face-to-face delivery, the organisation undertook a comprehensive review of its assessment strategy — looking across the complete programme of formative and summative assessment and asking a more fundamental question:
Are we assessing the right things, in the right way, using the right delivery model?
The approach
The review brought together assessment expertise, digital transformation, operational delivery, psychometrics and extensive stakeholder research.
The assessment programme was mapped against a new curriculum to understand what was being assessed, where gaps existed and whether individual capabilities were best assessed through summative examinations or in the workplace.
Alongside this, quantitative surveys and independently facilitated focus groups captured the experiences of candidates, supervisors, examiners, employers, patients and carers. International candidates were separately researched to understand their motivations, experiences and willingness to travel.
The analysis considered not just educational validity and reliability, but candidate experience, accessibility, equality and differential attainment, international reach, sustainability and operational feasibility.
What the evidence told us
There was no simple answer.
The digital clinical examination had proved that a complex, high-stakes assessment could be delivered remotely and reliably. Analysis found comparable reliability between digital and face-to-face delivery. Digital delivery also brought important benefits for candidates, including reduced travel and cost, improved accessibility for some groups and substantially lower carbon emissions.
But the evidence also identified limitations specific to what this particular clinical assessment was designed to measure.
Candidates, examiners and supervisors reported that physical examination and aspects of advanced communication — including non-verbal communication and empathy — were harder to demonstrate and assess through the video-consultation model.
The question therefore wasn't whether digital assessment worked. It was whether the delivery model was the best fit for the skills and capabilities this particular assessment needed to assess.
The solution
The resulting strategy wasn't a choice between “digital” and “traditional”.
The evidence supported returning the main clinical examination to face-to-face delivery because that environment was better suited to some of the skills it needed to assess.
At the same time, the review deliberately retained digital innovations where they added value. Written examinations remained computer-based, electronic marking was retained, and further digital elements within the clinical examination were proposed, including the potential assessment of video-consultation skills to reflect changing clinical practice.
The review also went considerably further than delivery mode. It resulted in a new assessment syllabus and blueprint aligned to the curriculum, recommendations for improved candidate feedback and preparation, further development of formative assessment, and a new governance structure providing strategic oversight of assessment.
The impact
The recommendations moved into implementation, with the clinical examination returning to face-to-face delivery in the UK and selected international markets while valuable digital elements were retained.
More fundamentally, the review provided an evidence-based roadmap for the future assessment programme: a clearer relationship between curriculum and assessment, a delivery model informed by validity and candidate experience, and a framework for the continued development and oversight of assessment.
The CX Works perspective
Assessment transformation shouldn't begin with a predetermined answer about technology.
The starting point is understanding what needs to be assessed, how it can best be assessed, and what candidates, assessors and the organisation need from the assessment model. Evidence can then guide decisions about delivery method, technology and operating model.
This project also demonstrates the importance of looking beyond the exam itself. Curriculum alignment, assessment validity, candidate experience, accessibility, operational delivery and governance all need to work together.
Good assessment doesn't start with the technology. It starts with what you need to assess — and then chooses the right method and technology to deliver it.