Aligning expectations and experiences: Medical student perspectives on progress testing for National Licensing...

The first medical students in the UK sat the General Medical Council's National Licensing Examination, known as the Applied Knowledge Test (AKT) in 2024. Some medical schools introduced Progress Tests (PTs) to prepare students for the AKT. This study aims to understand the expectations and experiences of the first medical students to take the AKT, prepared using PTs.

The setting was a predefined UK medical school who first administered the AKT in 2024. Using Psychological Contract as a conceptual framework, we interviewed eight Final Year students after completing their AKT. Transcribed data was coded into the analytical framework and agreed by the research team.

The expectations (promises) set by the medical school on PTs as preparation for the AKT did not initially align with the experience of students who used agency to self-teach content attempting to improve performance. However, on successfully passing their AKT, students reached a reciprocity point of agreement with the medical school's prior set expectations.

Whilst happy to pass the AKT, students described unresolved breaches that their learning for AKTs may not prepare them for their upcoming work as doctors. Early undertaking of the AKT allowed more time to prepare for clinical practice.