{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:16:20Z","timestamp":1787015780420,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010334","name":"Royal College of General Practitioners","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asmepublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Education"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>\n                      High\u2010stakes medical examinations seek to be fair to all candidates, including an increasing proportion of trainee doctors with specific learning differences. We aimed to investigate the performance of doctors declaring dyslexia in the clinical skills assessment (\n                      <jats:styled-content style=\"fixed-case\">CSA<\/jats:styled-content>\n                      ), an objective structured clinical examination for licensing\n                      <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                      general practitioners.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We employed a cross\u2010sectional design using performance and attribute data from candidates taking the\n                      <jats:styled-content style=\"fixed-case\">CSA<\/jats:styled-content>\n                      between 2010 and 2017. We compared candidates who declared dyslexia (\u2018early\u2019 before their first attempt or \u2018late\u2019 after failing at least once) with those who did not, using multivariable negative binomial regression investigating the effect of declaring dyslexia on passing the\n                      <jats:styled-content style=\"fixed-case\">CSA<\/jats:styled-content>\n                      , accounting for relevant factors previously associated with performance, including number of attempts, initial score, sex, place of primary medical qualification and ethnicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 20\u00a0879\n                      <jats:styled-content style=\"fixed-case\">CSA<\/jats:styled-content>\n                      candidates, 598 (2.9%) declared that they had dyslexia. Candidates declaring dyslexia were more likely to be male (47.3% versus 37.8%; p\u00a0&lt;\u00a00.001) and to have a non\u2010\n                      <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                      primary medical qualification (26.9% versus 22.4%; p\u00a0&lt;\u00a00.01), but were no different in ethnicity compared with those who never declared dyslexia. Candidates who declared dyslexia late were significantly more likely to fail compared with those candidates who declared dyslexia early (40.6% versus 9.2%; p\u00a0&lt;\u00a00.001) and were more likely to have a non\u2010\n                      <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                      medical qualification (79.3% versus 15.6%; p\u00a0&lt;\u00a00.001) or come from a minority ethnic group (84.9% versus 39.2%; p\u00a0&lt;\u00a00.001). The chance of passing was lower for candidates declaring dyslexia compared to those who never declared dyslexia and lower in those declaring late (incident rate ratio [\n                      <jats:styled-content style=\"fixed-case\">IRR<\/jats:styled-content>\n                      ], 0.82; 95% confidence interval [\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ], 0.70\u20130.96) compared with those declaring early (\n                      <jats:styled-content style=\"fixed-case\">IRR,<\/jats:styled-content>\n                      0.95; 95%\n                      <jats:styled-content style=\"fixed-case\">CI,<\/jats:styled-content>\n                      0.93\u20130.97).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      A small proportion of candidates declaring dyslexia were less likely to pass the\n                      <jats:styled-content style=\"fixed-case\">CSA<\/jats:styled-content>\n                      , particularly if dyslexia was declared late. Further investigation of potential causes and solutions is needed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/medu.13953","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T23:24:37Z","timestamp":1566343477000},"page":"1243-1252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Performance in candidates declaring versus those not declaring dyslexia in a licensing clinical examination"],"prefix":"10.1111","volume":"53","author":[{"given":"Zahid","family":"Asghar","sequence":"first","affiliation":[{"name":"Community and Health Research Unit (CaHRU) School of Health and Social Care University of Lincoln Lincoln UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicki","family":"Williams","sequence":"additional","affiliation":[{"name":"MRCGP Examinations RCGP London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Denney","sequence":"additional","affiliation":[{"name":"MRCGP Examinations RCGP London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2484-8201","authenticated-orcid":false,"given":"Aloysius Niroshan","family":"Siriwardena","sequence":"additional","affiliation":[{"name":"Community and Health Research Unit (CaHRU) School of Health and Social Care University of Lincoln Lincoln UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12613"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14739879.2016.1194170"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.15694\/mep.2017.000116"},{"key":"e_1_2_11_5_1","volume-title":"Equality Act 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