• Stephen Sciberras, Markus Klimek, Bazil Ateleanu, Hugues Scipioni, Rodolphe Di Loreto, and Joana Berger-Estilita.
• From the Department of Anaesthesia, ITU and Pain Management, Mater Dei Hospital, Msida, Malta (SS), Department of Anaesthesiology, Erasmus University Medical Centre, Rotterdam, the Netherlands (MK), European Society of Anaesthesiology and Intensive Care, Brussels, Belgium (MK, BA, HS, RDL, JBE), Department of Anaesthesia, University Hospital of Wales, Cardiff, UK (BA), Institute for Medical Education, University of Bern, Bern, Switzerland (JBE), CINTESIS@RISE - Centre for Health Technology and Services Research, Porto, Portugal (JBE) and Institute of Anaesthesiology and Intensive Care, Salemspital, Hirslanden Medical Group, Bern, Switzerland (JBE).
• Eur J Anaesthesiol. 2024 Aug 29.

BackgroundThe European Diploma of Anaesthesiology and Intensive Care (EDAIC) Part II examination is a supranational examination for anaesthesiologists.ObjectivesWe 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.DesignRetrospective cohort, observational design.SettingEDAIC Part II examination data from 2021 to 2023.ParticipantsThree hundred and twenty-five examiners across 122 EDAIC Part II examination sessions.InterventionsWe analysed the influence of examiner leniency and examiner pairing on candidate performance in the EDAIC Part II using many-facet Rasch modelling.Main Outcome MeasuresThe 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.ResultsDuring the study period, the number of examiners who participated in 2021, 2022 and 2023 were 253, 242 and 247, respectively. The median 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).ConclusionThe 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.Trial RegistrationNone.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society of Anaesthesiology.

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