On-Line Assessment (OLA) as a preparation for the European Diploma in Anaesthesiology and Intensive Care (EDAIC), a retrospective observational study on the results and the potential impact on the Part-I examination | Revista Española de Anestesiología y Reanimación (English Edition)

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PACU: Post anesthesia care unit." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Abdelbaser, N.A. Mageed, E.-S.M. El-Emam, M.M ALseoudy" "autores" => array:4 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Abdelbaser" ] 1 => array:2 [ "nombre" => "N.A." "apellidos" => "Mageed" ] 2 => array:2 [ "nombre" => "E.-S.M." 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Brogly, A. Varvinskiy, A. Varosyan, B. Ateleanu, W. Engelhardt, G. Geldner, K. Madách, E.M. Ringvold, M. Zerafa" "autores" => array:9 [ 0 => array:4 [ "nombre" => "N." "apellidos" => "Brogly" "email" => array:1 [ 0 => "nicolas.brogly@salud.madrid.org" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Varvinskiy" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Varosyan" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "B." 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"apellidos" => "Ringvold" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "i" "identificador" => "aff0045" ] ] ] 8 => array:3 [ "nombre" => "M." "apellidos" => "Zerafa" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "j" "identificador" => "aff0050" ] ] ] ] "afiliaciones" => array:10 [ 0 => array:3 [ "entidad" => "Examinations Committee of the European Society of Anaesthesiology and Intensive Care (ESAIC)" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Anaesthesiology and Intensive Care, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Anaesthesia and Intensive Care, Torbay Hospital, Torquay, UK" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Department of Anaesthesiology and Intensive Care, Yerevan State Medical University, Erebouni Medical Centre, Yerevan, Armenia" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Department of Anaesthesia, University Hospital of Wales, Cardiff, UK" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Department of Anaesthesiology and Intensive Care Medicine, Offenburg Hospital, Offenburg, Germany" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, RKH-Klinikum Ludwigsburg, Ludwigsburg, Germany" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "Department of Anaesthesiology, Pain Medicine and Intensive Care, Akershus University Hospital, Nordbyhagen, Norway" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Department of Anaesthesia and Intensive Care Medicine, Mater Dei Hospital, Msida, Malta" "etiqueta" => "j" "identificador" => "aff0050" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "On-Line Assessment (OLA) como preparación al Examen del Diploma Europeo de Anestesia y Cuidados Intensivos (EDAIC): estudio retrospectivo observacional sobre los resultados y el impacto sobre el examen Parte-I" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2584 "Ancho" => 2175 "Tamanyo" => 205859 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Number of attempts at Part I examination per candidate." ] ] ] "textoCompleto" => "IntroductionOver the past 10 years, the number of candidates applying for the European Diploma in Anaesthesiology and Intensive Care (EDAIC) has grown significantly<a class="elsevierStyleCrossRef" href="#bib0005">1</a>, and the diploma has permitted many European and non-European anaesthesiologists to reach European standards of knowledge in anaesthesiology and intensive care<a class="elsevierStyleCrossRef" href="#bib0010">2</a>. The exam consists of two summative assessments: Part I is a written examination comprising 2 multiple choice question (MCQ) papers, each containing Multiple True-False (MTF) questions on either Basic Science or Clinical Practice (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>-A); Part 2 is an oral examination based on 4 structured oral tests (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>-B)<a class="elsevierStyleCrossRefs" href="#bib0005">1,3,4</a>. The EDAIC has gradually been adopted as a national accreditive assessment, and part or all of the EDAIC is now mandatory in several European and other countries<a class="elsevierStyleCrossRef" href="#bib0005">1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>In order to help candidates prepare for the EDAIC, in 2011 the Examinations Committee of the European Society of Anaesthesiology and Intensive Care (ESAIC) developed the On-Line Assessment (OLA), a test that is very similar to the In-Training Assessment (ITA)<a class="elsevierStyleCrossRef" href="#bib0025">5</a>. The OLA has the same structure as the EDAIC Part I examination<a class="elsevierStyleCrossRef" href="#bib0030">6</a> and contains questions extracted from a separate bank of questions<a class="elsevierStyleCrossRef" href="#bib0030">6</a> that match the domains of the training syllabus of the European Union of Medical Specialists (EUMS)<a class="elsevierStyleCrossRef" href="#bib0035">7</a>. The OLA is posted on an online multilingual platform approximately 6 months before the Part I examination is held each April<a class="elsevierStyleCrossRef" href="#bib0030">6</a>. Examination centres have been approved in institutions in several countries, on the condition that they can provide a facility with an internet connection and an accredited host<a class="elsevierStyleCrossRef" href="#bib0040">8</a>. The Netherlands have mandated their residents to take the OLA every year as part of their national training programme, in order to assess the advances in their knowledge<a class="elsevierStyleCrossRef" href="#bib0045">9</a>. This innovative, interactive, easy online evaluation provides candidates with the high quality standards of the EDAIC using the latest technological advances in medical knowledge assessment.According to one study, the annual success rate of the EDAIC Part I examination is 57.9% (55.9%–59.9%)<a class="elsevierStyleCrossRef" href="#bib0015">3</a>. However, no data have been published on the results of the OLA and its impact on the EDAIC Part I examination. The members of the Examinations Committee of the EDAIC designed this observational study to assess the potential benefits of the OLA on the EDAIC Part I examination results.Material and methodsAuthorisation was obtained from the ESAIC Examinations Committee and secretariat to collect and analyse anonymously the results of the OLA and the EDAIC Part I examinations for this retrospective observational study. Ethical approval for this study was not required because no animals or patients were involved.We included all candidates who attempted the OLA or the EDAIC Part I examination between 2013 and 2019. The number of candidates for each examination per year was collected. For each candidate, we collected data on the type of examination attempted (OLA, EDAIC Part I examination or both) and the number of attempts made. The scores for Paper A (Basic Sciences) and Paper B (Clinical Practice) for each attempt were collected for both the OLA and the Part I examination.For the EDAIC Part I examination, we assessed the pass or fail result for each attempt and the final result for the entire cohort of candidates. This allowed us to calculate the number of attempts per candidate, the mean annual pass rate, and the success rate at each attempt. We also analysed the evolution of scores for Paper A and Paper B at each attempt for candidates registering several times for one or both exams.For the OLA, we assessed the evolution of registrations for the OLA over time and the number of registrations per candidate. For candidates who attempted the OLA several times, we assessed the evolution of their scores at each attempt, and the difference between Paper A and Paper B results at each attempt. In the subgroup of candidates who attempted both the OLA and the Part I examination in the same year, we assessed the difference in score between the OLA and Paper A and B of the EDAIC Part I examination on their first attempt.To assess the impact of the OLA on the EDAIC Part I examination, we compared the number of attempts at the Part I examination between candidates who had previously completed the OLA and those who had not. The final pass rate was analysed between both groups, and we performed a subgroup analysis per attempt for the overall success rate and the success rate per paper.Data were entered in a Microsoft Excel® v.16.42 (Microsoft, Redmond, WA, USA) spreadsheet and analysed separately for each examination using SPSS v.21 (IBM Corporation, Armonk, NY, USA). Results were presented as mean±standard deviation, median [range], or N (percentage), as appropriate. Odds Ratio (OR) of binary variables were presented with 95% confidence interval. The distribution was assessed using the Kolmogoroff-Smirnoff test and Q-Q-Plot analysis. Continuous variables were analysed using analysis of variance with Bonferroni post-hoc test or the Student’s t-test for independent groups, Kruskal-Wallis or Mann Whitney tests were performed in data with non-normal distribution. Categorical variables were analysed using Chi-square test for trends or Fisher’s exact-test, as appropriate. A Pearson correlation test was used to identify relationships between continuous variables. The level of statistical significance was set at 0.05.ResultsBetween 2013 and 2019, 17,401 candidates took at least one of the two written EDAIC examinations at least once: 3121 candidates registered only for the OLA, 12,173 only for the Part I examination and 2016 for both the OLA and the Part I examination. Candidates from Spanish speaking countries (Spain, Argentina, Chile, Colombia, Costa Rica, and Venezuela) accounted for 1793/17,401 (10.3%) of all candidates. The total number of registrations for both the OLA and the Part I examination increased significantly over this period (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) (p<0.0001 for both exams).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Results of the Part I examinationCandidates sitting the EDAIC Part I examination made 1 (1;7) attempt (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The mean yearly pass rate was 57.9% (55.9%;59.9%).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>The overall pass rate for the Part I examination for this cohort of candidates between 2013 and 2019 was 68.95% (9,784 candidates ultimately passed, and 4,405 candidates failed), taking into consideration that candidates that failed were able to sit the examination again in consecutive years until they passed.The pass rate for the Part I examination decreased with the number of attempts made: 8719/14,188 (61.5%) at the first attempt, 934/1698 (55.0%) at the second attempt, and 202/513 (39.4%) after 3 or more attempts (p<0.0001).The increase in number of attempts at the Part I Examination was accompanied by a decrease in scores for both Paper A (p<0.0001) and Paper B (p<0.0001), as shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>, and explains the resulting decrease in the pass rate for the Part I examination.<elsevierMultimedia ident="fig0015"></elsevierMultimedia>Results of the OLAThe total number of registrations per year for the OLA has increased significantly over time, in parallel with the increase in registrations for the Part I examination (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The annual number of registrations for the OLA correlates with the number of registrations for the Part I examination (r2=0.76, 95%CI [0.34; 0.98], p=0.01).Candidates taking the OLA make 1.20 ± 1.00 (Median 1.00 Range [1;5]) attempts. The OLA candidates who subsequently took the Part I examination made a higher number of attempts at the OLA than those only taking the OLA (OLA: 1 [1;4] attempts; OLA-Part-1: 1 [1;5] attempts; p<0.001).Candidates who took the OLA several times had a significantly higher score in Paper A, correlating with the number of attempts at the OLA (Year-1: 65.48±7.82%; Year-2: 68.82±6.30; Year-3: 67.65±6.15%; Year-4:69.26±4.79%; p=0.006) (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>-A). However, the increase in scores for Paper B did not reach statistical significance in consecutive years (Year-1: 69.85+6.07%; Year-2: 70.41+5.94%; Year-3: 70.82+4.57%; Year-4: 73.34+3.70; p=0.13) (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>-B).<elsevierMultimedia ident="fig0020"></elsevierMultimedia>Scores for Paper B were significantly higher than for Paper A for the first year (mean difference [MD]: +4.06±6.18%; p<0.0001), the second year (MD: +3.49±5.90%; p<0.0001) and the third year (MD: +3.14±3.67%; p=0.007), but not for the fourth year (MD: +4.25±7.48%; p=0.34).The OLA score at the first attempt among candidates who sat both the OLA and the Part I examination was lower than that of both Papers A and B of the EDAIC Part I, with a difference of 4.91±6.49% points (p<0.0001), and 3.07±4.90% points (p<0.0001) respectively.Impact of the OLA on Part I examination resultsThe OLA had a positive impact on Part I examination results in the period between 2013 and 2019: 1467/2,012 (72.9%) candidates who took OLA prior to doing the EDAIC Part I examination passed the EDAIC Part I examination, compared with 8,317/12,173 (68.3%) of candidates who took the Part I examination only (OR: 1.25; 95% CI [1.12; 1.39]; p<0.001).An analysis of the subgroups of candidates at each attempt of the Part I examination (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) showed that candidates who completed the OLA before EDAIC Part I had a greater probability of passing if they sat the examination 2 or 3 times, but this benefit was not observed on the first attempt at EDAIC I and in candidates who failed the Part I examination more than 3 times.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Aside from their final result, candidates who sat the OLA before the EDAIC Part I examination were more likely to take the Part I examination several times than those who only took the Part I examination, 396/2015 (19.7%) versus 1815/12,173 (14.9%), OR: 1.396, 95% CI [1.237; 1.574]; p<0.001), with a higher number of attempts at the Part I examination (1.26±0.62 versus 1.19±0.52; p<0.001).DiscussionThis study showed that the OLA appears to be an efficient tool for preparing candidates to pass the Part I examination. It allows candidates who sat the OLA various times to improve their results in the Basic Sciences paper, in contrast to those who took the Part I examination several times, for whom the number of passes decreased on successive attempts. This suggests that candidates taking the OLA were particularly interested in increasing their chances of passing the examination, either because they were particularly ambitious or determined, or because they had received their training in a more supportive or demanding system. Even though the effect of the OLA on the Part I examination results was not evident at the first attempt, the overall pass rate for Part I was higher among candidates who had previously taken the OLA.After the first pilot examination in May 2011, the OLA was offered from 2013 to all centres willing to participate, and the number of candidates increased considerably over the following years until the OLA became the biggest online examination ever organised in Anaesthesiology and Intensive Care, with more than 1500 candidates in 2019 <a class="elsevierStyleCrossRef" href="#bib0050">10</a>. Various courses have been organised to prepare for the EDAIC in countries where it is not mandatory, and some have shown promising results<a class="elsevierStyleCrossRef" href="#bib0055">11</a>. Since 2012, the ESAIC has organised the Basic and Clinical Science Anaesthesia Course (BCSAC), which covers the more important topics included in the examination syllabus<a class="elsevierStyleCrossRef" href="#bib0060">12</a>.An important argument for encouraging trainees to sit the OLA is that knowledge is not the only factor that contributes to success in exams — an understanding of the structure of the examination and the answering technique can make the difference between passing and failing<a class="elsevierStyleCrossRef" href="#bib0065">13</a>. Unfortunately, not all training programmes use MTF MCQs. The OLA offers candidates useful feedback to help them focus their revision in the months leading up to the examination, and the course is reasonably priced because the structure and examination conditions are identical to the Part I examination<a class="elsevierStyleCrossRef" href="#bib0030">6</a>.Even though the OLA is not per se a training programme, it reflects the candidate’s level of preparation for the EDAIC. In a recent retrospective study of Spanish candidates, lack of knowledge in basic sciences contributed to failure in the Part I examination in 84.1% of cases<a class="elsevierStyleCrossRef" href="#bib0015">3</a>. Improving anaesthesiology, intensive care and pain medicine trainees’ knowledge of basic science is an important future goal. In our study, candidates that took the OLA several times progressively increased their score in basic sciences. This could be used as an argument to encourage trainees to take and repeat the OLA during their residency in order to ensure that they are fully prepared when they register for the EDAIC Part I examination.In our study, the difference between the OLA and Part I results of approximately 5% for Paper A and 3% for Paper B are an indicator of the improvement achieved by candidates who chose to sit the OLA before sitting the EDAIC Part I examination approximately 6 months later, and could help candidates to choose the best time to register for the Part I examination.The gradual improvement observed in our study in the basic sciences score over successive years might have been due to the inclusion and regular repetition of OLA in the Dutch training programme<a class="elsevierStyleCrossRef" href="#bib0045">9</a>. This is also an indication that knowledge progressively increases along with training. Hence, it is important to compare the score obtained in the OLA with each candidate’s stage of training. Some authors also highlight the fact that assessment drives learning<a class="elsevierStyleCrossRef" href="#bib0070">14</a>, insofar as the obligation to take different assessments from an early stage of residency encourages trainees to adopt a study habit and focus on mastering the scientific material that will be the foundation for their future training.Many teaching programmes in anaesthesiology include activities to boost knowledge and competencies<a class="elsevierStyleCrossRef" href="#bib0075">15</a>. In 2013, the European Board of Anaesthesiology and the Anaesthesiology Section of the European Union of Medical Specialists (EBA-UEMS) created the European Training Requirements (ETR), which are defined as the expected competencies and knowledge that an anaesthesiologist should acquire to become a specialist<a class="elsevierStyleCrossRef" href="#bib0035">7</a>. In their latest version, they recommended a combination of formative and summative assessment modalities to assess the competencies acquired in anaesthesiology, intensive care, emergency and pain medicine<a class="elsevierStyleCrossRef" href="#bib0010">2</a>. As domains of the ETR were included in the OLA and the EDAIC Part I exams, the EDAIC was endorsed by the EBA-UEMS<a class="elsevierStyleCrossRef" href="#bib0020">4</a>.The free circulation of professionals between European Union countries since 2005<a class="elsevierStyleCrossRef" href="#bib0080">16</a> has led to the creation of a series of rules governing training in medical specialties. In anaesthesiology, intensive care and pain medicine, the ESAIC and EBA-UEMS have focused on harmonising the knowledge and training of specialists in order to reduce the considerable differences found among the competencies required to become a specialist<a class="elsevierStyleCrossRef" href="#bib0085">17</a>. More recently, the EBA-UEMS defined “competency-based medical education and training” (CBMET)<a class="elsevierStyleCrossRef" href="#bib0090">18</a> as a means of changing anaesthesiology, intensive care and pain medicine training from a time-based to a competency-based programme. This new strategy includes the requirement to assess the resident’s knowledge and competencies, and the OLA and EDAIC are useful tools for assessing knowledge.Both the ETR and CBMET promote the development and maintenance of a high degree of professional competence among anaesthesiologists, based on lifelong learning. In this context, the OLA would be an excellent tool to assess the level of knowledge of European specialists for appraisal, re-accreditation and/or revalidation purposes.Our study has various limitations. Even though the OLA was associated with better score in the EDAIC Part I, this does not necessarily mean that candidates have a better knowledge base — they might simply be more skilled in examination techniques. Another limitation is that we did not differentiate between the candidate’s year of residency, which could have differed considerably; however, our large sample of candidates gives a global picture of the results of the OLA. In addition, our results were pooled for the whole period. Even though the examination papers were different every year, the interannual mean scores were not significantly different for either the Part I examination and the OLA between 2013 and 2019. Finally, differences between training programmes still exist in the different countries where the OLA is available, and this could lead to disparity in the scores obtained in the OLA. However, the main goal of the OLA is to prepare candidates for the EDAIC Part I examination, so this assessment might reduce the differences in the EDAIC Part I Examination scores arising from different styles of teaching in different training programmes<a class="elsevierStyleCrossRef" href="#bib0095">19</a>.ConclusionsThe number of candidates taking the OLA has increased significantly in the past 8 years, and the examination appears to be a valuable and inexpensive tool for preparing residents for the EDAIC Part I examination. Even though it is essentially a mock test for the actual EDAIC Part I examination, residents who took the OLA each year during their training programme showed steady improvement in scores over time and an overall higher success rate than those who did not. Finally, the OLA would be an interesting tool for re-accrediting an anaesthesiologist’s level of knowledge in the future.FundingNone.Conflicts of interestNone.Authors’ contributionN. Brogly participated in the study design, the results analysis and the manuscript editing,A. Varvinskiy original idea, participated in the study design, the manuscript editing and reviewing,A. Varosyan participated in the study design, the manuscript editing and reviewing,B. Ateleanu participated in the manuscript editing and reviewing,W. Engelhardt participated in the study design, the manuscript editing and reviewing,G. Geldner participated in the manuscript editing and reviewing,K. Madách participated in the manuscript editing and reviewing,E.-M. Ringvold participated in the study design, the manuscript editing and reviewingM. Zerafa participated in the study design, the manuscript editing and reviewing." "textoCompletoSecciones" => array:1 [ "secciones" => array:14 [ 0 => array:3 [ "identificador" => "xres1776673" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1560077" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1776674" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1560076" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Results of the Part I examination" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Results of the OLA" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Impact of the OLA on Part I examination results" ] ] ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0050" "titulo" => "Conflicts of interest" ] 11 => array:2 [ "identificador" => "sec0055" "titulo" => "Authors’ contribution" ] 12 => array:2 [ "identificador" => "xack627840" "titulo" => "Acknowledgements" ] 13 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-04-21" "fechaAceptado" => "2021-07-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1560077" "palabras" => array:5 [ 0 => "Education in anaesthesiology" 1 => "European Diploma in Anaesthesiology and Intensive Care" 2 => "Online Assessment" 3 => "Formative assessment" 4 => "Knowledge" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1560076" "palabras" => array:5 [ 0 => "Educación en anestesiología" 1 => "Diploma Europeo de Anestesiología y Cuidados Intensivos" 2 => "Evaluación en línea" 3 => "Evaluación formativa" 4 => "Conocimientos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "BackgroundThe EDAIC is a diploma of the European Society of Anaesthesiology and Intensive Care (ESAIC). which is obtained after passing two a written MCQ-based (Part1) and a structured oral (part2) examinationIn 2011, a formative On-Line Assessment (OLA) was introduced to help candidates to prepare for EDAIC Part1 examination (EDAIC-I). This retrospective observational study evaluated the results of the OLA and its impact on the EDAIC-1 between 2013 and 2019. MethodsAfter obtaining the authorisation from the ESAIC Examinations Committee, all the results of candidates registered to OLA and/or EDAIC-I between 2013 and 2019 were included. The total number of registrations and the results were analysed and compared for both. ResultsOver 17,000 candidates (17,401) sat any of the written exams of the EDAIC. The overall pass-rate for the EDAIC-1 was 68.95%. The OLA score increased significantly with the number of attempts for Paper A (Basic Science) (p=0.006).Overall success of the EDAIC-I was higher in candidates who took the OLA before (72.9% versus 68.3%; OR: 1.25; 95% CI [1.12; 1.39]; p<0.001). Candidates who failed in their first attempt for EDAIC-I were more likely to sit the exam again if they had performed the OLA before (OR: 1.396, 95% CI [1.237; 1.574]; p<0.001). ConclusionThe OLA was associated with an improvement of the results in basic science and success rate in the EDAIC-I." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl EDAIC es un diploma de la Sociedad Europea de Anestesia y Cuidados intensivos (ESAIC)obtenido tras aprobar dos exámenes, una primera parte escrita con preguntas de tipo test y una segunda parte oral estructurada. En 2011, otra prueba formativa en línea (el OnLine Assessment, OLA) fue introducida para ayudar los candidatos a prepararse para el primer examen (EDAIC-I). Este estudio retrospectivo observacional fue diseñado para evaluar los resultados del OLA y su impacto sobre el EDAIC-I entre 2013 y 2019. MétodosDespués de obtener la autorización del comité examinador de la ESAIC, todos los resultados de los candidatos registrados para el OLA y/o el EDAIC-I entre 2013 y 2019 fueron incluidos. El número total de inscripciones y los resultados fueron analizados y comparados para ambas pruebas. ResultadosMás de 17.000 candidatos (17.401) presentaron cualquiera de los exámenes escritos del EDAIC. La tasa de aprobados en el EDAIC-I fue del 68,95%. La nota en el OLA aumentó de manera significativa en intentos sucesivos para el Paper A (Ciencias Básicas) (p=0,006)La tasa global de aprobados en el EDAIC-I fue más alta en los candidatos que habían presentado el OLA antes (72,9% versus 68,3%; OR: 1,25; 95% CI [1,12; 1,39]; p<0,001). Los candidatos que fallaron en el primer intento al EDAIC-I repitieron más el examen si habían realizado el OLA (OR: 1.396, 95% CI [1.237; 1.574]; p<0.001). ConclusiónEl OLA fue asociado a un aumento de los resultados en ciencias básicas y de la tasa de aprobados en el EDAIC-I." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:6 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1828 "Ancho" => 2175 "Tamanyo" => 208886 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Number of registrations per year for OLA and EDAIC Part I examinations." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2584 "Ancho" => 2175 "Tamanyo" => 205859 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Number of attempts at Part I examination per candidate." ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1441 "Ancho" => 2175 "Tamanyo" => 166607 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "EDAIC Part I results over successive attempts at Paper A (A) and Paper B (B). Scores are expressed as percentage of correct answers, with mean and standard deviation" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1051 "Ancho" => 2175 "Tamanyo" => 180418 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Results of OLA over successive years for the same candidates for paper A (4-A) and paper B (4-B). Scores are expressed as percentage of correct answers, with mean and standard deviation." ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:2 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1-A: OLA and Part-I Examination contents</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper A: Basic Science: 60 MTF MCQs:</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper B: Clinical Practice: 60 MTF MCQs:</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiorespiratory Physiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.1–Q.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General Anaesthesia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.1–Q.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neurophysiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.11–Q.13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Local, Regional Anaesthesia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.16–Q20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General physiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.14–Q.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Special Anaesthesia and Pain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.21–Q.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiovascular Pharmacology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.21–Q.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intensive Care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.36–Q.45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Central Nervous System Pharmacology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.24–Q.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Internal Medicine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.46–Q.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General Pharmacology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.28–Q.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Emergency Medicine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.54–Q.60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General Physics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.41–Q.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical measurement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.49–Q.58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Statistics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q.59–Q.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] 1 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1-B: Part-II Examination composition</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basic Science Structured Oral examinations: 25min of examination per table \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical Practice Structured Oral Examinations: 25min of examination per table \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MORNING: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AFTERNOON: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Table 1 (Applied Basic Science) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Table 3 (Clinical - Critical care subject) intensive care or emergency medicine scenario: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. applied cardiovascular and/or respiratory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1-2. clinical management \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. physiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. Critical incident \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. applied anatomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. Pain/local or regional anaesthesia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. physiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. general questions \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. physiology/pharmacology combined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Table 2 (Applied Basic Science) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Table 4 (Clinical - anaesthetic problem) anaesthetic problem scenario: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. applied pharmacology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1-2. 2 questions on the scenario \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. applied Pharmacology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. questions on an internal medicine topic \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. clinical measurement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. Images interpretation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. General pharmacology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. general questions \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. applied pharmacology/physiology combined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Structure of the EDAIC Examinations: OLA and EDAIC Part-I (1-A) and EDAIC Part-II (1-B)." ] ] 5 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Part-1 Success \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No OLA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OLA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR [95%CI], p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">First attempt: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N=14,190 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7449/12,173 (61.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1270/2015 (63.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.08 [0.98;1.19]; p=0.117 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8437/12,173 (69.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1453/2017 (72.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.14 [1.03; 1.27], p=0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8331/12,173 (68.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1426/2017 (70.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.08 [0.98; 1.20], p=0.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Second attempt: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N=2217 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">769/1818 (42.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">190/399(49.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.34 [1.08;1.67], p=0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">997/1818 (54.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">247/399 (61.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.34 [1.07;1.67], p=0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">969/1818 (53.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">238/399 (59.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.30 [1.04;1.61], p=0.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Third attempt: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N=514 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">131/423(31.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38/53 (41.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.60 [1.03;2.56], p=0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">199/423 (47.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52/91 (57.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.50 [0.95;2.35], p=0.08 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">176/247 (41.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49/91 (53.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.64 [1.04;2.54], p=0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fourth attempt: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N=122 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22/96 (22.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8/26 (30.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.50 [0.57;3.67], p=0.45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39/96 (40.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12/26 (46.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.25 [0.55;3.09], p=0.66 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paper B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34/96 (35.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12/26 (46.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.56 [0.68;3.90], p=0.36 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Results of Part I examination expressed as pass rate comparing candidates who took the OLA assessment before the EDAIC-I examinations with those who did not. Results are expressed as N (percentage)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The European Diploma in Anaesthesiology and Intensive Care (EDAIC)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W. Engelhardt" 1 => "G. 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Original article

On-Line Assessment (OLA) as a preparation for the European Diploma in Anaesthesiology and Intensive Care (EDAIC), a retrospective observational study on the results and the potential impact on the Part-I examination

On-Line Assessment (OLA) como preparación al Examen del Diploma Europeo de Anestesia y Cuidados Intensivos (EDAIC): estudio retrospectivo observacional sobre los resultados y el impacto sobre el examen Parte-I

N. Broglya,b,

Corresponding author

nicolas.brogly@salud.madrid.org

Corresponding author.

, A. Varvinskiya,c, A. Varosyana,d, B. Ateleanua,e, W. Engelhardta,f, G. Geldnera,g, K. Madácha,h, E.M. Ringvolda,i, M. Zerafaa,j

a Examinations Committee of the European Society of Anaesthesiology and Intensive Care (ESAIC)

b Department of Anaesthesiology and Intensive Care, Hospital Universitario La Paz, Madrid, Spain

c Department of Anaesthesia and Intensive Care, Torbay Hospital, Torquay, UK

d Department of Anaesthesiology and Intensive Care, Yerevan State Medical University, Erebouni Medical Centre, Yerevan, Armenia

e Department of Anaesthesia, University Hospital of Wales, Cardiff, UK

f Department of Anaesthesiology and Intensive Care Medicine, Offenburg Hospital, Offenburg, Germany

g Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, RKH-Klinikum Ludwigsburg, Ludwigsburg, Germany

h Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary

i Department of Anaesthesiology, Pain Medicine and Intensive Care, Akershus University Hospital, Nordbyhagen, Norway

j Department of Anaesthesia and Intensive Care Medicine, Mater Dei Hospital, Msida, Malta

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Part 2 is an oral examination based on 4 structured oral tests &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>-B&#41;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;4</span></a>&#46; The EDAIC has gradually been adopted as a national accreditive assessment&#44; and part or all of the EDAIC is now mandatory in several European and other countries<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">In order to help candidates prepare for the EDAIC&#44; in 2011 the Examinations Committee of the European Society of Anaesthesiology and Intensive Care &#40;ESAIC&#41; developed the On-Line Assessment &#40;OLA&#41;&#44; a test that is very similar to the In-Training Assessment &#40;ITA&#41;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46; The OLA has the same structure as the EDAIC Part I examination<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> and contains questions extracted from a separate bank of questions<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> that match the domains of the training syllabus of the European Union of Medical Specialists &#40;EUMS&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; The OLA is posted on an online multilingual platform approximately 6 months before the Part I examination is held each April<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; Examination centres have been approved in institutions in several countries&#44; on the condition that they can provide a facility with an internet connection and an accredited host<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46; The Netherlands have mandated their residents to take the OLA every year as part of their national training programme&#44; in order to assess the advances in their knowledge<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; This innovative&#44; interactive&#44; easy online evaluation provides candidates with the high quality standards of the EDAIC using the latest technological advances in medical knowledge assessment&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">According to one study&#44; the annual success rate of the EDAIC Part I examination is 57&#46;9&#37; &#40;55&#46;9&#37;&#8211;59&#46;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; However&#44; no data have been published on the results of the OLA and its impact on the EDAIC Part I examination&#46; The members of the Examinations Committee of the EDAIC designed this observational study to assess the potential benefits of the OLA on the EDAIC Part I examination results&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">Authorisation was obtained from the ESAIC Examinations Committee and secretariat to collect and analyse anonymously the results of the OLA and the EDAIC Part I examinations for this retrospective observational study&#46; Ethical approval for this study was not required because no animals or patients were involved&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">We included all candidates who attempted the OLA or the EDAIC Part I examination between 2013 and 2019&#46; The number of candidates for each examination per year was collected&#46; For each candidate&#44; we collected data on the type of examination attempted &#40;OLA&#44; EDAIC Part I examination or both&#41; and the number of attempts made&#46; The scores for Paper A &#40;Basic Sciences&#41; and Paper B &#40;Clinical Practice&#41; for each attempt were collected for both the OLA and the Part I examination&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">For the EDAIC Part I examination&#44; we assessed the pass or fail result for each attempt and the final result for the entire cohort of candidates&#46; This allowed us to calculate the number of attempts per candidate&#44; the mean annual pass rate&#44; and the success rate at each attempt&#46; We also analysed the evolution of scores for Paper A and Paper B at each attempt for candidates registering several times for one or both exams&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">For the OLA&#44; we assessed the evolution of registrations for the OLA over time and the number of registrations per candidate&#46; For candidates who attempted the OLA several times&#44; we assessed the evolution of their scores at each attempt&#44; and the difference between Paper A and Paper B results at each attempt&#46; In the subgroup of candidates who attempted both the OLA and the Part I examination in the same year&#44; we assessed the difference in score between the OLA and Paper A and B of the EDAIC Part I examination on their first attempt&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">To assess the impact of the OLA on the EDAIC Part I examination&#44; we compared the number of attempts at the Part I examination between candidates who had previously completed the OLA and those who had not&#46; The final pass rate was analysed between both groups&#44; and we performed a subgroup analysis per attempt for the overall success rate and the success rate per paper&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Data were entered in a Microsoft Excel&#174; v&#46;16&#46;42 &#40;Microsoft&#44; Redmond&#44; WA&#44; USA&#41; spreadsheet and analysed separately for each examination using SPSS v&#46;21 &#40;IBM Corporation&#44; Armonk&#44; NY&#44; USA&#41;&#46; Results were presented as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#44; median &#91;range&#93;&#44; or N &#40;percentage&#41;&#44; as appropriate&#46; Odds Ratio &#40;OR&#41; of binary variables were presented with 95&#37; confidence interval&#46; The distribution was assessed using the Kolmogoroff-Smirnoff test and Q-Q-Plot analysis&#46; Continuous variables were analysed using analysis of variance with Bonferroni post-hoc test or the Student&#8217;s <span class="elsevierStyleItalic">t</span>-test for independent groups&#44; Kruskal-Wallis or Mann Whitney tests were performed in data with non-normal distribution&#46; Categorical variables were analysed using Chi-square test for trends or Fisher&#8217;s exac<span class="elsevierStyleItalic">t</span>-test&#44; as appropriate&#46; A Pearson correlation test was used to identify relationships between continuous variables&#46; The level of statistical significance was set at 0&#46;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Between 2013 and 2019&#44; 17&#44;401 candidates took at least one of the two written EDAIC examinations at least once&#58; 3121 candidates registered only for the OLA&#44; 12&#44;173 only for the Part I examination and 2016 for both the OLA and the Part I examination&#46; Candidates from Spanish speaking countries &#40;Spain&#44; Argentina&#44; Chile&#44; Colombia&#44; Costa Rica&#44; and Venezuela&#41; accounted for 1793&#47;17&#44;401 &#40;10&#46;3&#37;&#41; of all candidates&#46; The total number of registrations for both the OLA and the Part I examination increased significantly over this period &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for both exams&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results of the Part I examination</span><p id="par0055" class="elsevierStylePara elsevierViewall">Candidates sitting the EDAIC Part I examination made 1 &#40;1&#59;7&#41; attempt &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The mean yearly pass rate was 57&#46;9&#37; &#40;55&#46;9&#37;&#59;59&#46;9&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The overall pass rate for the Part I examination for this cohort of candidates between 2013 and 2019 was 68&#46;95&#37; &#40;9&#44;784 candidates ultimately passed&#44; and 4&#44;405 candidates failed&#41;&#44; taking into consideration that candidates that failed were able to sit the examination again in consecutive years until they passed&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The pass rate for the Part I examination decreased with the number of attempts made&#58; 8719&#47;14&#44;188 &#40;61&#46;5&#37;&#41; at the first attempt&#44; 934&#47;1698 &#40;55&#46;0&#37;&#41; at the second attempt&#44; and 202&#47;513 &#40;39&#46;4&#37;&#41; after 3 or more attempts &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The increase in number of attempts at the Part I Examination was accompanied by a decrease in scores for both Paper A &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; and Paper B &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#44; and explains the resulting decrease in the pass rate for the Part I examination&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results of the OLA</span><p id="par0075" class="elsevierStylePara elsevierViewall">The total number of registrations per year for the OLA has increased significantly over time&#44; in parallel with the increase in registrations for the Part I examination &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The annual number of registrations for the OLA correlates with the number of registrations for the Part I examination &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;76&#44; 95&#37;CI &#91;0&#46;34&#59; 0&#46;98&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Candidates taking the OLA make 1&#46;20 &#177; 1&#46;00 &#40;Median 1&#46;00 Range &#91;1&#59;5&#93;&#41; attempts&#46; The OLA candidates who subsequently took the Part I examination made a higher number of attempts at the OLA than those only taking the OLA &#40;OLA&#58; 1 &#91;1&#59;4&#93; attempts&#59; OLA-Part-1&#58; 1 &#91;1&#59;5&#93; attempts&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Candidates who took the OLA several times had a significantly higher score in Paper A&#44; correlating with the number of attempts at the OLA &#40;Year-1&#58; 65&#46;48<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;82&#37;&#59; Year-2&#58; 68&#46;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;30&#59; Year-3&#58; 67&#46;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;15&#37;&#59; Year-4&#58;69&#46;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;79&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>-A&#41;&#46; However&#44; the increase in scores for Paper B did not reach statistical significance in consecutive years &#40;Year-1&#58; 69&#46;85<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6&#46;07&#37;&#59; Year-2&#58; 70&#46;41<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5&#46;94&#37;&#59; Year-3&#58; 70&#46;82<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4&#46;57&#37;&#59; Year-4&#58; 73&#46;34<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>3&#46;70&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;13&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>-B&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Scores for Paper B were significantly higher than for Paper A for the first year &#40;mean difference &#91;MD&#93;&#58; &#43;4&#46;06<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;18&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#44; the second year &#40;MD&#58; &#43;3&#46;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;90&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; and the third year &#40;MD&#58; &#43;3&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;67&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#44; but not for the fourth year &#40;MD&#58; &#43;4&#46;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;48&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;34&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The OLA score at the first attempt among candidates who sat both the OLA and the Part I examination was lower than that of both Papers A and B of the EDAIC Part I&#44; with a difference of 4&#46;91<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;49&#37; points &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#44; and 3&#46;07<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;90&#37; points &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; respectively&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Impact of the OLA on Part I examination results</span><p id="par0100" class="elsevierStylePara elsevierViewall">The OLA had a positive impact on Part I examination results in the period between 2013 and 2019&#58; 1467&#47;2&#44;012 &#40;72&#46;9&#37;&#41; candidates who took OLA prior to doing the EDAIC Part I examination passed the EDAIC Part I examination&#44; compared with 8&#44;317&#47;12&#44;173 &#40;68&#46;3&#37;&#41; of candidates who took the Part I examination only &#40;OR&#58; 1&#46;25&#59; 95&#37; CI &#91;1&#46;12&#59; 1&#46;39&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">An analysis of the subgroups of candidates at each attempt of the Part I examination &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; showed that candidates who completed the OLA before EDAIC Part I had a greater probability of passing if they sat the examination 2 or 3 times&#44; but this benefit was not observed on the first attempt at EDAIC I and in candidates who failed the Part I examination more than 3 times&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Aside from their final result&#44; candidates who sat the OLA before the EDAIC Part I examination were more likely to take the Part I examination several times than those who only took the Part I examination&#44; 396&#47;2015 &#40;19&#46;7&#37;&#41; versus 1815&#47;12&#44;173 &#40;14&#46;9&#37;&#41;&#44; OR&#58; 1&#46;396&#44; 95&#37; CI &#91;1&#46;237&#59; 1&#46;574&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; with a higher number of attempts at the Part I examination &#40;1&#46;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;62 versus 1&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;52&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">This study showed that the OLA appears to be an efficient tool for preparing candidates to pass the Part I examination&#46; It allows candidates who sat the OLA various times to improve their results in the Basic Sciences paper&#44; in contrast to those who took the Part I examination several times&#44; for whom the number of passes decreased on successive attempts&#46; This suggests that candidates taking the OLA were particularly interested in increasing their chances of passing the examination&#44; either because they were particularly ambitious or determined&#44; or because they had received their training in a more supportive or demanding system&#46; Even though the effect of the OLA on the Part I examination results was not evident at the first attempt&#44; the overall pass rate for Part I was higher among candidates who had previously taken the OLA&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">After the first pilot examination in May 2011&#44; the OLA was offered from 2013 to all centres willing to participate&#44; and the number of candidates increased considerably over the following years until the OLA became the biggest online examination ever organised in Anaesthesiology and Intensive Care&#44; with more than 1500 candidates in 2019 <a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; Various courses have been organised to prepare for the EDAIC in countries where it is not mandatory&#44; and some have shown promising results<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Since 2012&#44; the ESAIC has organised the Basic and Clinical Science Anaesthesia Course &#40;BCSAC&#41;&#44; which covers the more important topics included in the examination syllabus<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">An important argument for encouraging trainees to sit the OLA is that knowledge is not the only factor that contributes to success in exams &#8212; an understanding of the structure of the examination and the answering technique can make the difference between passing and failing<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#46; Unfortunately&#44; not all training programmes use MTF MCQs&#46; The OLA offers candidates useful feedback to help them focus their revision in the months leading up to the examination&#44; and the course is reasonably priced because the structure and examination conditions are identical to the Part I examination<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Even though the OLA is not <span class="elsevierStyleItalic">per se</span> a training programme&#44; it reflects the candidate&#8217;s level of preparation for the EDAIC&#46; In a recent retrospective study of Spanish candidates&#44; lack of knowledge in basic sciences contributed to failure in the Part I examination in 84&#46;1&#37; of cases<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Improving anaesthesiology&#44; intensive care and pain medicine trainees&#8217; knowledge of basic science is an important future goal&#46; In our study&#44; candidates that took the OLA several times progressively increased their score in basic sciences&#46; This could be used as an argument to encourage trainees to take and repeat the OLA during their residency in order to ensure that they are fully prepared when they register for the EDAIC Part I examination&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In our study&#44; the difference between the OLA and Part I results of approximately 5&#37; for Paper A and 3&#37; for Paper B are an indicator of the improvement achieved by candidates who chose to sit the OLA before sitting the EDAIC Part I examination approximately 6 months later&#44; and could help candidates to choose the best time to register for the Part I examination&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The gradual improvement observed in our study in the basic sciences score over successive years might have been due to the inclusion and regular repetition of OLA in the Dutch training programme<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; This is also an indication that knowledge progressively increases along with training&#46; Hence&#44; it is important to compare the score obtained in the OLA with each candidate&#8217;s stage of training&#46; Some authors also highlight the fact that assessment drives learning<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#44; insofar as the obligation to take different assessments from an early stage of residency encourages trainees to adopt a study habit and focus on mastering the scientific material that will be the foundation for their future training&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Many teaching programmes in anaesthesiology include activities to boost knowledge and competencies<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#46; In 2013&#44; the European Board of Anaesthesiology and the Anaesthesiology Section of the European Union of Medical Specialists &#40;EBA-UEMS&#41; created the European Training Requirements &#40;ETR&#41;&#44; which are defined as the expected competencies and knowledge that an anaesthesiologist should acquire to become a specialist<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; In their latest version&#44; they recommended a combination of formative and summative assessment modalities to assess the competencies acquired in anaesthesiology&#44; intensive care&#44; emergency and pain medicine<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; As domains of the ETR were included in the OLA and the EDAIC Part I exams&#44; the EDAIC was endorsed by the EBA-UEMS<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The free circulation of professionals between European Union countries since 2005<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> has led to the creation of a series of rules governing training in medical specialties&#46; In anaesthesiology&#44; intensive care and pain medicine&#44; the ESAIC and EBA-UEMS have focused on harmonising the knowledge and training of specialists in order to reduce the considerable differences found among the competencies required to become a specialist<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#46; More recently&#44; the EBA-UEMS defined &#8220;competency-based medical education and training&#8221; &#40;CBMET&#41;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> as a means of changing anaesthesiology&#44; intensive care and pain medicine training from a time-based to a competency-based programme&#46; This new strategy includes the requirement to assess the resident&#8217;s knowledge and competencies&#44; and the OLA and EDAIC are useful tools for assessing knowledge&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Both the ETR and CBMET promote the development and maintenance of a high degree of professional competence among anaesthesiologists&#44; based on lifelong learning&#46; In this context&#44; the OLA would be an excellent tool to assess the level of knowledge of European specialists for appraisal&#44; re-accreditation and&#47;or revalidation purposes&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Our study has various limitations&#46; Even though the OLA was associated with better score in the EDAIC Part I&#44; this does not necessarily mean that candidates have a better knowledge base &#8212; they might simply be more skilled in examination techniques&#46; Another limitation is that we did not differentiate between the candidate&#8217;s year of residency&#44; which could have differed considerably&#59; however&#44; our large sample of candidates gives a global picture of the results of the OLA&#46; In addition&#44; our results were pooled for the whole period&#46; Even though the examination papers were different every year&#44; the interannual mean scores were not significantly different for either the Part I examination and the OLA between 2013 and 2019&#46; Finally&#44; differences between training programmes still exist in the different countries where the OLA is available&#44; and this could lead to disparity in the scores obtained in the OLA&#46; However&#44; the main goal of the OLA is to prepare candidates for the EDAIC Part I examination&#44; so this assessment might reduce the differences in the EDAIC Part I Examination scores arising from different styles of teaching in different training programmes<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusions</span><p id="par0165" class="elsevierStylePara elsevierViewall">The number of candidates taking the OLA has increased significantly in the past 8 years&#44; and the examination appears to be a valuable and inexpensive tool for preparing residents for the EDAIC Part I examination&#46; Even though it is essentially a mock test for the actual EDAIC Part I examination&#44; residents who took the OLA each year during their training programme showed steady improvement in scores over time and an overall higher success rate than those who did not&#46; Finally&#44; the OLA would be an interesting tool for re-accrediting an anaesthesiologist&#8217;s level of knowledge in the future&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Funding</span><p id="par0170" class="elsevierStylePara elsevierViewall">None&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">None&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Authors&#8217; contribution</span><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">N&#46; Brogly</span> participated in the study design&#44; the results analysis and the manuscript editing&#44;</p><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A&#46; Varvinskiy</span> original idea&#44; participated in the study design&#44; the manuscript editing and reviewing&#44;</p><p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A&#46; Varosyan</span> participated in the study design&#44; the manuscript editing and reviewing&#44;</p><p id="par0195" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">B&#46; Ateleanu</span> participated in the manuscript editing and reviewing&#44;</p><p id="par0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">W&#46; Engelhardt</span> participated in the study design&#44; the manuscript editing and reviewing&#44;</p><p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">G&#46; Geldner</span> participated in the manuscript editing and reviewing&#44;</p><p id="par0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">K&#46; Mad&#225;ch</span> participated in the manuscript editing and reviewing&#44;</p><p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">E&#46;-M&#46; Ringvold</span> participated in the study design&#44; the manuscript editing and reviewing</p><p id="par0220" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">M&#46; Zerafa</span> participated in the study design&#44; the manuscript editing and reviewing&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The EDAIC is a diploma of the European Society of Anaesthesiology and Intensive Care &#40;ESAIC&#41;&#46; which is obtained after passing two a written MCQ-based &#40;Part1&#41; and a structured oral &#40;part2&#41; examinationIn 2011&#44; a formative On-Line Assessment &#40;OLA&#41; was introduced to help candidates to prepare for EDAIC Part1 examination &#40;EDAIC-I&#41;&#46; This retrospective observational study evaluated the results of the OLA and its impact on the EDAIC-1 between 2013 and 2019&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">After obtaining the authorisation from the ESAIC Examinations Committee&#44; all the results of candidates registered to OLA and&#47;or EDAIC-I between 2013 and 2019 were included&#46; The total number of registrations and the results were analysed and compared for both&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Over 17&#44;000 candidates &#40;17&#44;401&#41; sat any of the written exams of the EDAIC&#46; The overall pass-rate for the EDAIC-1 was 68&#46;95&#37;&#46; The OLA score increased significantly with the number of attempts for Paper A &#40;Basic Science&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Overall success of the EDAIC-I was higher in candidates who took the OLA before &#40;72&#46;9&#37; versus 68&#46;3&#37;&#59; OR&#58; 1&#46;25&#59; 95&#37; CI &#91;1&#46;12&#59; 1&#46;39&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Candidates who failed in their first attempt for EDAIC-I were more likely to sit the exam again if they had performed the OLA before &#40;OR&#58; 1&#46;396&#44; 95&#37; CI &#91;1&#46;237&#59; 1&#46;574&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The OLA was associated with an improvement of the results in basic science and success rate in the EDAIC-I&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">El EDAIC es un diploma de la Sociedad Europea de Anestesia y Cuidados intensivos &#40;ESAIC&#41;obtenido tras aprobar dos ex&#225;menes&#44; una primera parte escrita con preguntas de tipo test y una segunda parte oral estructurada&#46; En 2011&#44; otra prueba formativa en l&#237;nea &#40;el OnLine Assessment&#44; OLA&#41; fue introducida para ayudar los candidatos a prepararse para el primer examen &#40;EDAIC-I&#41;&#46; Este estudio retrospectivo observacional fue dise&#241;ado para evaluar los resultados del OLA y su impacto sobre el EDAIC-I entre 2013 y 2019&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Despu&#233;s de obtener la autorizaci&#243;n del comit&#233; examinador de la ESAIC&#44; todos los resultados de los candidatos registrados para el OLA y&#47;o el EDAIC-I entre 2013 y 2019 fueron incluidos&#46; El n&#250;mero total de inscripciones y los resultados fueron analizados y comparados para ambas pruebas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">M&#225;s de 17&#46;000 candidatos &#40;17&#46;401&#41; presentaron cualquiera de los ex&#225;menes escritos del EDAIC&#46; La tasa de aprobados en el EDAIC-I fue del 68&#44;95&#37;&#46; La nota en el OLA aument&#243; de manera significativa en intentos sucesivos para el Paper A &#40;Ciencias B&#225;sicas&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">La tasa global de aprobados en el EDAIC-I fue m&#225;s alta en los candidatos que hab&#237;an presentado el OLA antes &#40;72&#44;9&#37; versus 68&#44;3&#37;&#59; OR&#58; 1&#44;25&#59; 95&#37; CI &#91;1&#44;12&#59; 1&#44;39&#93;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los candidatos que fallaron en el primer intento al EDAIC-I repitieron m&#225;s el examen si hab&#237;an realizado el OLA &#40;OR&#58; 1&#46;396&#44; 95&#37; CI &#91;1&#46;237&#59; 1&#46;574&#93;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">El OLA fue asociado a un aumento de los resultados en ciencias b&#225;sicas y de la tasa de aprobados en el EDAIC-I&#46;</p></span>"
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                  \t\t\t\t">Paper A&#58; Basic Science&#58; 60 MTF MCQs&#58;</td><td class="td" title="\n
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                  \t\t\t\t">Cardiorespiratory Physiology&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">General Anaesthesia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Q&#46;1&#8211;Q&#46;15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Special Anaesthesia and Pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;21&#8211;Q&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiovascular Pharmacology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;21&#8211;Q&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intensive Care&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;36&#8211;Q&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Central Nervous System Pharmacology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;24&#8211;Q&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Internal Medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;46&#8211;Q&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">General Pharmacology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;28&#8211;Q&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emergency Medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;54&#8211;Q&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">General Physics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;41&#8211;Q&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clinical measurement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;49&#8211;Q&#46;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Statistics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Q&#46;59&#8211;Q&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            1 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1-B&#58; Part-II Examination composition</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Basic Science Structured Oral examinations&#58; 25<span class="elsevierStyleHsp" style=""></span>min of examination per table&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clinical Practice Structured Oral Examinations&#58; 25<span class="elsevierStyleHsp" style=""></span>min of examination per table&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MORNING&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AFTERNOON&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Table 1 &#40;Applied Basic Science&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Table 3 &#40;Clinical - Critical care subject&#41; intensive care or emergency medicine scenario&#58;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46; applied cardiovascular and&#47;or respiratory&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1-2&#46; clinical management&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46; physiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46; Critical incident&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46; applied anatomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46; Pain&#47;local or regional anaesthesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46; physiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46; general questions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46; physiology&#47;pharmacology combined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Table 2 &#40;Applied Basic Science&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Table 4 &#40;Clinical - anaesthetic problem&#41; anaesthetic problem scenario&#58;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46; applied pharmacology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1-2&#46; 2 questions on the scenario&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46; applied Pharmacology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46; questions on an internal medicine topic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46; clinical measurement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46; Images interpretation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46; General pharmacology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46; general questions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46; applied pharmacology&#47;physiology combined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Structure of the EDAIC Examinations&#58; OLA and EDAIC Part-I &#40;1-A&#41; and EDAIC Part-II &#40;1-B&#41;&#46;</p>"
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        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "identificador" => "at0030"
            "detalle" => "Table "
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        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Part-1 Success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No OLA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OLA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR &#91;95&#37;CI&#93;&#44; <span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">First attempt</span>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#44;190&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7449&#47;12&#44;173 &#40;61&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1270&#47;2015 &#40;63&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;08 &#91;0&#46;98&#59;1&#46;19&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8437&#47;12&#44;173 &#40;69&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1453&#47;2017 &#40;72&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;14 &#91;1&#46;03&#59; 1&#46;27&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8331&#47;12&#44;173 &#40;68&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1426&#47;2017 &#40;70&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;08 &#91;0&#46;98&#59; 1&#46;20&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Second attempt</span>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">769&#47;1818 &#40;42&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">190&#47;399&#40;49&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;34 &#91;1&#46;08&#59;1&#46;67&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">997&#47;1818 &#40;54&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">247&#47;399 &#40;61&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;34 &#91;1&#46;07&#59;1&#46;67&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">969&#47;1818 &#40;53&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">238&#47;399 &#40;59&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;30 &#91;1&#46;04&#59;1&#46;61&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Third attempt</span>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>514&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">131&#47;423&#40;31&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#47;53 &#40;41&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;60 &#91;1&#46;03&#59;2&#46;56&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">199&#47;423 &#40;47&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#47;91 &#40;57&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;50 &#91;0&#46;95&#59;2&#46;35&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">176&#47;247 &#40;41&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#47;91 &#40;53&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;64 &#91;1&#46;04&#59;2&#46;54&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fourth attempt</span>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>122&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;96 &#40;22&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#47;26 &#40;30&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;50 &#91;0&#46;57&#59;3&#46;67&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#47;96 &#40;40&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#47;26 &#40;46&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;25 &#91;0&#46;55&#59;3&#46;09&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paper B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#47;96 &#40;35&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#47;26 &#40;46&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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