Structured Assessment using Multiple Patient Scenarios (StAMPS)

Primary Rural and Remote Training

Preparing for the StAMPS assessment process

The aim of StAMPS assessment modality is to test higher order functions in a highly contextualised framework where candidates have the opportunity to explain what they do and demonstrate their clinical reasoning, as opposed to simply providing evidence of knowledge, listing facts or recalling protocols.

The StAMPS is essentially a viva voce examination, with 1 or 2 simulated patients or consult with a professional colleague (such as a telephone consult with a remote area nurse in a neighbouring community).

Registrars are strongly advised to consider the curriculum and prescribed reading list when preparing for the assessment, as well as familiarising themselves with the format of this assessment modality. The Assessment Blueprint provides a good guide as to which domain areas the StAMPS examination will focus on.

What does StAMPS assess?

1. Is the registrar a safe clinician to work both independently and unsupervised in rural and/or remote general practice?
2. Does the registrar demonstrate clinical reasoning rather than simply listing knowledge?
3. Has the candidate presented their answers in the context of the set geographical and logistical environment where the exam is set?

How does it work?

Candidates are provided with the ‘Appointment Sheet’ two days before the exam. This document details the setting where the examination is deemed to be taking place and the context in which the candidate is required to answer the questions. Each actual examination has an ‘Appointment Sheet’ specific to that examination.

The examinations consist of 8 scenarios, each of which takes 10 minutes to complete. The candidate remains in the same room for the duration of the examination, with the examiners moving from room to room between scenarios. The scenarios cover a broad range of topics chosen from across the entire breadth and depth of the curriculum and are contextualised to the seven domains.

Candidates are provided with 10 minutes reading time prior to the start of the examination, when they can read the ‘candidate material’ for each of the 8 scenarios and make notes. Candidates are provided with paper and pencils on the day of the exam.

Each scenario consists of 2-4 core questions. The examiner may also provide prompts where necessary to assist the candidate.

Between each scenario, the candidates have 5 minutes to read the ‘candidate material’ for the next scenario and make notes.

The examiners assess the candidate’s performance across six categories (below) using a global assessment scale.

1. Communication
2. Define the problem systematically
3. Develop appropriate management plan that incorporates relevant contextual factors
4. Be flexible in response to new information
5. Demonstrates rural context
6. Overall Impression

The Global Assessment scale has four categories

1. Excellent (the examiner considers that the registrar demonstrated a very high level of competency)
2. Satisfactory  (the examiner considers that for the curriculum and domains covered by the scenario that the registrar is considered safe to practice independently and unsupervised in the context of rural and/or remote general practice)
3. Borderline (the examiner considers that the registrar is not yet ready to practice independantly or unsupervised – in this category it may be that some of the elements of the scenario were well covered, but not in others or that the overall performance was below that expected for a satisfactory grade)
4. Unsatisfactory (the examiner considers that from the information gathered in the scenario that the registrar is not yet safe to be practicing independently or unsupervised – this grade is also awarded in the situation where a registrar’s discussion would result in a critical – potentially life threatening or significant morbity – outcome for patient presenting with a given problem).

Main issues to be demonstrated are identified, however there is no one perfect answer; candidates do not necessarily need to exhaustively list information to pass; and there may be a number of different perfectly reasonable approaches to answering the questions posed.

Practice Scenarios

Two detailed scenarios are provided - 2011 and 2010A.

Detailed notes and video footage are provided. Candidates are advised to focus on the process of this assessment modality rather than the content of this single sample scenario. As detailed above, the actual assessment involves 8 scenarios, each of 10 minutes duration.

Suggested time for completion of each scenario is exercise is 1 to 2 hours.

Note: The video is specifically designed to generate consideration and discussion and is not a portrayal of the ‘correct’ answer. The StAMPS practice scenario videos demonstrate only part of a scenario; in the actual examination, each scenario runs for 10 minutes.

Practice scenario 2011

The format suggested for using this material is:

1. Familiarise yourself with the StAMPS Process Rules and Regulations page 48 of the Handbook for Fellowship Assessment document.
2. Familiarise yourself with the geographic and demographic setting of this practice examination as detailed in the Appointment Sheet. Please note: in your actual examination, this will be different.
3. Familiarise yourself with the information provided to examiners: StAMPS Practice Scenario 2011 Examiner Scenario Sheet and StAMPS Practice Scenario 2011: Marking Sheet
4. Read the StAMPS Practice Scenario 2011 Candidate Printed Information Sheet: Make some notes that you think may be relevant to this scenario.
5. Watch the video StAMPS 2011 Practice Scenario: Version A
6. Consider your score of this candidate using the StAMPS Practice Scenario 2011: Marking Sheet
7. Watch the video StAMPS 2011 Practice Scenario Version B
8. Consider your score of this candidate using the StAMPS Practice Scenario 2011: Marking Sheet
9. Compare your responses with the Key Concepts / Main Issues to be Demonstrated as detailed in the StAMPS Practice Scenario 2011 Examiner Scenario Sheet. How did you grade Version A and B?
10. Here are examples of a completed marking sheet by an examiner for Version A and Version B with comments included.
11. What are the main differences between your marking and the examiner? Use this information to consider the expected level at this exam. Note:  Both versions are somewhat shorter (especially B) than in the actual exam.
12. Reconsider how you would now answer this question.
13. If possible, discuss your thoughts with others within your learning environment.

Practice Question 2010A

Note: Since December 2010 the format of the scenarios has been changed to present a more integrated approach. The video scenario provided in this section is focused on a public health issue alone. Currently, scenarios have other components in addition.  Eg: a scenario may ask for a discussion of chronic disease management of a common condition and then may ask how you would approach related issues from a public health perspective.  However, the video is still useful in considering how to approach the StAMPS exmination. 

The format suggested for using this material is:

1. Read the StAMPS 2010 Practice Examination: Introductory Notes explaining the examination process.

2. Familiarise yourself with the StAMPS 2010 Practice Examination: Scoring Sheet

3. Familiarise yourself with the geographic and demographic setting of this practice examination as detailed in the StAMPS 2010 Practice Examination Appointment Sheet

Please note: The appointment sheet is provided to candidates the day before the exam. Each actual examination has an appointment sheet specific to that examination.

4. Read the StAMPS 2010A Practice Examination: Candidate Reading Material

Please note: In an actual examination, this is provided to the candidate at the start of the pre-examination reading time. Candidates are free to write notes during reading time, and during the five-minute gap between scenarios.

5. Read the StAMPS 2010A Practice Examination: Examination Scenario

Please note: In an actual examination, this is read out by the examiner during the scenario.

6. Consider how you would address this question

7. Watch the video StAMPS 2010A Practice Scenario: Version A

• Consider your score of this candidate using the StAMPS 2010 Practice Examination: Scoring Sheet

8. Watch the video StAMPS 2010A Practice Scenario: Version B

• Consider your score of this candidate using the StAMPS 2010 Practice Examination: Scoring Sheet
• Compare your responses with the StAMPS 2010A Practice Question: Key Item List.

9. Revisit each video and rescore the performance of each version against the StAMPS 2010A Practice Question: Key Item List

10. Compare your original scoring sheets with these second versions.

11. What are the main differences between your two marking efforts?

12.Reconsider how you would now answer this question.

13. If possible, discuss your thoughts with others within your learning environment.

Practice Question 2010B, 2010C, 2010D, 2010E

These questions are provided in outline format only. Hence the StAMPS 2010 Practice Examination: Other Questions (Viva Voce) provides only the ‘candidate reading material’ and ‘questions to be answered’, while the StAMPS 2010 Practice Examination: Other Questions (Simulation) provides only the ‘candidate reading material’ and ‘what the simulated patient will reveal when asked’. It is suggested that these questions are used to guide practical training sessions with your usual educational providers