The ‘renewed’ European Diploma in Intensive Care examination: an evidence-based change

Introduction: In the Netherlands summative end-of-training clinical assessment of Dutch intensive care medicine trainees is performed using the European Diploma in Intensive Care Medicine (EDIC) format. The format for this EDIC part II exam has recently changed, moving away from the clinical bedside assessment towards Objective Structured Clinical Examinations (OSCEs). Methods: A national study using all examination data for the Netherlands in the period 2010 to 2013 was initiated. The goal was to identify whether, and to what extent, the different components of the clinical part (II) of the EDIC exam (the OSCEs (paper-based, clinically oriented cases) long case (bedside, clinical) and short cases (bedside, clinical)) correlated in order to determine whether moving away from the clinical, bedside EDIC assessment in the ‘renewed’ EDIC exam is supported by the data. Results: Pearson correlation of the OSCE score with the long case and short cases score was moderate to strong and significant (0.43 and 0.37, at the 0.01 level and 0.05 level, respectively). Correlation of the long case score with the short cases score was moderate (0.28) and non-significant. Factor analysis revealed only one factor with an eigenvalue above 1. The OSCE component of the EDIC II exam contributed most strongly to this factor, followed by the long case and short cases. Conclusion: The study’s findings support moving away from the clinical bedside assessment, towards OSCE type examination stations as are now incorporated in the recently introduced revised summative EDIC II examination framework.