Abstract
The Applied Knowledge Test (AKT) is one arm of the tripod of assessments that forms the MRCGP examination. It is therefore a test that needs to be taken by all GP specialty trainees as a compulsory part of the route to their Certificate of Completion of Training (CCT).
This paper, and one that follows in a future issue of InnovAiT, aims to provide an introduction to the design and structure of the AKT and give you some advice about the practicalities of preparing for and sitting your exam
How is the AKT designed?
The AKT is a computer-based test consisting of 200 question items. The reliability and validity of this assessment are internationally acknowledged and it is subject to a continual cycle of quality assurance. All the members of the group that write questions for the AKT are practicing clinical GPs, and the questions they design are based on real-life knowledge. AKT questions need to be relevant to UK primary care and, as such, cover the whole GP curriculum. Box 1 summarizes the content of a typical AKT paper.
What question formats are there?
Single best answer questions
In single best answer (SBA) questions, either a clinical scenario or a factual statement is given with a list of five possible options. Only ‘one’ option can be chosen and you have to decide which is the ‘most’ appropriate. You may feel that your ideal answer is not included in the available options but you still need to select the most appropriate option from the list you have been given.
Extended matching questions
For extended matching (EM) questions, typically, eight options are listed and then a series of two or three clinical scenarios is described. The option that best matches each scenario has to be selected. It should be noted that the same answer might apply to more than one scenario and conversely, some statements will not apply to any of the successive scenarios.
AKT content
Freetext questions
Freetext was a new question format in the last two diets of the AKT and is set to stay. These questions might require a clinical diagnosis, numerical calculation or drug dosage to be typed into a Freetext box. There is no list of distracters to help cue the correct answer. Although marked by computer, all the answers are manually checked to ensure that acceptable spellings or unit variations are credited.
What might accompany the questions?
A clinical photograph and/or graph could be used in SBA, EM or Freetext questions. The image quality is good and the graphs are often anonymized equivalents of those that primary care organizations, as well as medical journals, frequently use and expect GPs to understand. A short video could also be included with either a SBA or a Freetext question associated with it.
Finding examples of these question formats
You can find examples of the different question formats on the AKT page of the Royal College of General Practitioners (RCGP) exam website. InnovAiT also regularly features examples of AKT style questions.
Booking your AKT exam
You must apply to sit your AKT examination through your RCGP online account. Once your application has been received, you will receive an email with details of how to book a test. Taking the AKT late in the ST2 year (having prepared well) seems to be a good time, and the pass rates are similar for first-time ST2 or ST3 takers.
It is essential that you take an approved photographic identification document that matches your registration details on the day. If you use a professional name that differs from the name on your approved photographic identification document (for example if you practice in your maiden name but have a passport or driving licence in your married name), your application details must match your photographic identification. Remember that if you arrive late at the test centre at which you have booked, you will not be allowed in.
Any AIT entering Specialist training from August 2010 has a maximum of four attempts at the AKT and a pass remains valid until your CCT is completed. Different regulations apply to those who started training before August 2010 and it is important to check the applicable regulations if there are any queries.
Disabilities
If you have a disability, it is crucial to contact the RCGP as early as possible before you even book your exam, to discuss any adjustments that you might require, such as extra time if you are dyslexic.
Preparing for your AKT
Sitting the AKT is a challenge and it can be reassuring to know that most candidates will pass it on their first attempt, but achieving such success requires effective preparation. My next article will hopefully give you some useful advice about how to prepare for the exam and best utilize those resources that are available to help you.