Influence of pairing in examiner leniency and stringency ('hawk-dove effect') in part II of the European Diploma of Anaesthesiology and Intensive Care A cohort study

BACKGROUND The European Diploma of Anaesthesiology and Intensive Care (EDAIC) Part II examination is a supranational examination for anaesthesiologists. OBJECTIVE(S) We explore the impact of examiner pairing on leniency and stringency, commonly referred to as the 'hawk-dove effect'. We investigate the potential variations in grading approaches, resulting from different examiner pairs and their implications for candidate performance. DESIGN Retrospective cohort, observational design. SETTING EDAIC Part II examination data from 2021 to 2023. PARTICIPANTS Three hundred and twenty-five examiners across 122 EDAIC Part II single-day examination sessions. INTERVENTION(S) We analysed the influence of examiner leniency and examiner pairing on candidate performance in the EDAIC Part II using many-facet Rasch modelling. MAIN OUTCOME MEASURES The study's main outcome measure was determining a leniency score among the examiner population. The study also aimed to assess how examiner pairing influenced candidate performance, as measured by their scores in the examination. RESULTS During the study period, the number of examiners who participated in 2021, 2022 and 2023 were 253, 242 and 247, respectively. The median [IQR] single-day sessions attended were 7.0 [3 to 10]. The examination data revealed a mean leniency score of 0 (95% confidence interval (CI) -0.046 to 0.046), with the standard deviation being one-third that of the candidates' ability scores. There were 1424 different pairs of examiners, with most pairs (97%) having only a one-point difference in marking. The mean leniency score for the pair of examiners was -0.053 (95% CI -0.069 to -0.037). CONCLUSION The variations in grading approaches associated with different pairings emphasise the potential for the 'hawk-dove effect' to influence candidate performance and outcomes. Understanding these variations can guide curriculum development, examiner training and coupling, ensuring a balanced and equitable assessment process.