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The ‘viva voce’ examination has been a tradition in surgical training for over a century, and remains a key element of the ‘Fellowship of the Royal College of Surgeons' (FRCS) Examination, which neurosurgery trainees must pass to complete their training. The aims of this study were to evaluate the educational value of an annual ‘mock viva’ as a formative assessment tool for neurosurgical trainees during their eight year training programme, to identify barriers to participating in the mock viva and to explore how these might be attenuated to increase levels of engagement. A mixed deductive and inductive methodology was employed for the study design and qualitative data analysis. Semi structured interviews were conducted with two cohorts of trainees (three pre-FRCS and three post-FRCS). Six overarching themes emerged from thematic analysis of coded qualitative data – ‘insight’, ‘performance’, ‘simulation’, ‘stress’, ‘differentiation strategies’, and ‘assessment versus learning’. Gaining insight into the format, standard, marking scheme, and processes of the final FRCS examination were considered key elements of the educational value of the mock viva and these were perceived to be acquired through high fidelity simulation of the FRCS exam, with high quality feedback on performance. The opportunity to observe the assessment of others offered insight into one's performance relative to peers as well as insight the perspective of the examiner conducting the assessment. Whilst they acknowledged negative 'stress' factors associated with the mock viva, post-FRCS trainees underscored the benefits of learning from substandard performances; of reflecting on these experiences and on the feedback they received, and they suggested that junior trainees lacked insight into the educational value of what are often perceived to be ‘negative’ experiences. Junior trainees were concerned that the potential learning value of the mock viva process was limited by their clinical knowledge and experience in the early stage of training. These overarching themes point to areas which could be targeted to enhance the educational value of the mock viva and to address the paradox of poor uptake amongst junior trainees.

Neurosurgery Trainees’ Perspectives of the ‘Mock Viva’