Nationwide cross-sectional survey on the necessity of including a clinical skills assessment in the national licensure examination for Doctors of Korean Medicine

Clinical skills assessment (CSA) has been implemented in the licensure examination of many healthcare professionals to ensure the required performance in clinical practice. Despite the high demand revealed in previous surveys, CSA has not yet been implemented in the national licensure examination (NLE) for Doctors of Korean Medicine (DKMs). Furthermore, discussions on expected outcomes and examination blueprints remain fragmented. Here, we present the perceptions of DKMs on CSA in the NLE: what should be assessed, when to implement, and the characteristics of DKMs who favor or oppose CSA. A voluntary and anonymous online nationwide cross-sectional survey was conducted in August 2022. The questionnaire included questions on demographic characteristics, whether CSA is required in the NLE for DKMs, priority of competencies to be assessed, appropriate time of introduction, and specific items to be included. Suggestions and concerns regarding the CSA were collected comprehensively through open-ended questions. Approximately 8.7% of DKMs (n = 2221 of 25,500) participated in the survey. Regarding the necessity of introducing CSA in the NLE for DKMs, 81.9% agreed, 10.8% were neutral, and 7.3% disagreed. The top prioritized competency for the CSA was "patient care," followed by "clinical skills" and "completion of the medical record." Clinical presentations of various symptoms, such as headache, low back pain, chronic abdominal pain, dizziness, diarrhea, and dysmenorrhea, were prioritized items for the patient encounter test. For the procedural skills test, DKMs in primary clinics perceived tongue and pulse diagnoses as necessary, whereas those in public medical institutions and hospitals deemed most examinations necessary. CSA has been perceived as highly necessary for inclusion in the NLE for DKMs, particularly with regard to priorities that reflect DKMs' duties and actual clinical practice. While our survey cannot determine causality, it provides important preliminary evidence and serves as a foundational resource for future research and decision-making in competency-based Korean Medicine education and evaluation.