The extended functional practical examination (EFPE): an innovative model for advancing assessment for learning in postgraduate medical education

Abstract

The Extended Functional Practical Exam (EFPE) is an innovative postgraduate assessment model designed to overcome the limitations of traditional single-point practical examinations by adopting a longitudinal, experiential, and institution-based approach. This study aimed to critically explore the implementation of EFPE across different medical schools and examine its perceived educational value, impact on learners and institutions, and areas for improvement. A reflective qualitative study involving different medical schools was conducted. Three samples were included in the study: a convenience sample of the postgraduate students and a purposive, convenience sample of faculty members and medical school stakeholders. Insights from the three samples were collected through semi-structured interviews. All the interviews were audio recorded and transcribed verbatim and thematically analyzed. The thematic analysis of data from the three samples (S1, S2, and S3) under the classified themes revealed several themes and subthemes. The main themes included the format and differences from traditional exams, the exam’s impact, and challenges and areas for improvement. Participants appreciate the alignment of EFPE tasks with institutional needs and the positive role of feedback and mentorship. However, challenges such as stress, workload, resource demands, and issues with topic selection and clarity were noted. EFPE is highly valued for its practical, structured, and process-focused approach, which leads to significant skill development and confidence building among postgraduate students. Suggestions from participants include extending the duration of the EFPE, involving students in topic selection, maintaining continuous feedback and mentorship, and ensuring tasks are relevant and sustainable.