Ministry of Education

Test Blueprint for National Exit Examination to be held in 2015 E.C

Band 3

Program: - Bachelor of Science Degree in Anesthesia

Compiled By:

1. Yohannes Molla (Jhpiego, Ethiopia); Yohannes.Asemu@jhpiego.org

2. Astemamagn Achule (Arba Minch University); astemamagn.achule@gmail.com
3. Tadese Tamire (Debre Tabor University); tadesetamire@gmail.com

February, 2023

Addis Ababa, Ethiopia

Table of Contents

1
Contents
Introduction...........................................................................................................................................3
Objective of Test Blueprint...................................................................................................................3
Expected Profile of the Graduates.........................................................................................................4
Objectives of the Program.....................................................................................................................4
General Objective..............................................................................................................................4
Specific Objectives............................................................................................................................4
Themes and list of modules/courses with Credit Hours.........................................................................5
Share of the Themes/Courses/Items in Percentage (%).........................................................................6
Test blueprint Table (Table of Specification)........................................................................................0
Learning outcomes in terms of the three domains (Cognitive, Affective and Psychomotor)...............21
Conclusion...........................................................................................................................................23

2
Introduction
The Ministry of Education of Ethiopia has announced the implementation of exit exam for all
undergraduate program students (public and private), beginning with the 2022/2023 academic year, in
order to improve the quality of graduates produced by higher learning institutions. The exit exam
aimed at checking whether students have acquired the required knowledge, skills and attitudes or not.
To implement this, it requires determining competency areas for a specific program, which is already
completed. Based on the competency areas prepared, it needs to plan the construction of tests.

Planning of a test is a first and vital step in the construction of an achievement test. An achievement
test demands very systematic and careful planning, as a fact that good planning is a symbol of
success. Tests are the tools that provide scores that measure level of student learning and study
program learning outcomes. In order to achieve the valid and reliable measurement of student
learning and program learning outcomes, the development of valid and reliable test is the mandatory.
Test should be able to measure student performance in all dimensions of knowledge, skill and
attitude. The carefully planned test construction contributes to improve the overall quality of the test
in terms of test content validity, difficulty level, discrimination power and test reliability. Test
preparation is not an easy task; it requires a careful planning and guideline to make the task simple.
Test construction needs the preparation of test blue print. Test blueprint is defined as a complete plan
that explains how to develop a test. The term refers to a map or specification of assessment to ensure
that all aspects of the curriculum and educational domains are covered by the assessment programs
over a specified period of time. It helps curriculum developers/test constructors to match various
competencies with the course content and the appropriate modality of assessment.

Generally, test blueprint will help to ensure tests: 1) Appropriately assess the achievement of
instructional objectives of the course; 2) Appropriately reflect key course goals, objectives and the
material learned or covered during the instruction period; and 3) Include the appropriate item formats
along with the knowledge and skills being assessed.
Keeping this in mind, the team has prepared this test blueprint document in order to help the test
developers or content specialists in their process of valid and reliable test construction. The major
points considered in the process of preparing this test blue print guideline were the core
competencies that have been already identified for the themes of courses, the course contents, course
credit hours, and the learning outcomes with their corresponding levels of achievement by learning
domains. In line with these, the number of test items that should adequately assess the performance
of students in all the content topics will be determined through discussion with the content specialists
who construct the blueprint and test for their corresponding study program.

Therefore, the main purpose of this manual is to give direction on how to develop exit exam for
content specialists so that they can develop a representative and balanced exam for their respective
program.

Objective of Test Blueprint

Test blueprint preparation is generally opted to assist the preparation of a test that is representative,
broadly sampled, and consisting of complete knowledge domain expected of Anesthesia students up
on completion of their study program. The specific objectives of test blueprint are to:
 Facilitate the construction of a representative and balanced test items for the selected courses
in accordance with the competencies identified.
 Guide test developers or writers to write or set appropriate test items.

3
Expected Profile of the Graduates
Upon completion of the training, the graduates will be able to:

Perform comprehensive pre-anesthesia patient assessment including taking history, performing a

physical examination, order and interpret relevant investigations and obtain informed consent
Prepare and optimize patients for surgery and Anesthesia
Utilize Anesthesia equipment, monitoring devises, medical gas sources, anesthetic agents and
supplies according to the acceptable practice standards and protocols
Apply standard safety measures to manage perioperative hazards
Manage patient airways using different modalities
Manage Anesthesia for different general and urologic surgical procedures
Manage Anesthesia for obstetrics and gynecologic surgeries
Manage Anesthesia for trauma and orthopedic surgeries
Manage Anesthesia for geriatric patients undergoing surgeries
Manage Anesthesia for pediatric and neonatal surgeries
Manage Anesthesia for emergency thoracic surgeries
Manage Anesthesia for ophthalmic surgeries
Manage Anesthesia for maxillofacial and ENT surgeries
Manage Anesthesia for neurosurgeries
Manage remote Anesthesia
Provide postoperative care to a surgical patient
Engage in the patient discharge process from PACU
Assess and manage acute pain
Participate in the management of chronic and cancer pain
Perform different regional blocks for pain management service
Engage in the initial assessment and stabilization of critically ill patients
Engage in the management of emergency and critically ill patients
Perform effective Basic and Advanced Life Support (BLS and ALS)
Demonstrate professionalism in Anesthesia practice
Engage in the conduct of research relevant to Anesthesia services
Apply the principles of evidence-based practice
Conduct a clinical audit and need assessment
Develop, implement and monitor the overall Anesthesia service plan in a facility
Adapt and implement a quality improvement and assurance framework for quality Anesthesia
service delivery

Objectives of the Program

General Objective
To produce competent Anesthesia professionals who will provide the full scope of Anesthesia service,
as defined by the professional scope of practice, with good knowledge, clinical skills, attitude, and
critical thinking abilities.
Specific Objectives
 To equip Anesthesia professionals with solid knowledge of biomedical science, clinical and
public health practice
 Prepare Anesthesia students to assess and optimize patients with co-morbidity for surgery and
Anesthesia

4
  Prepare Anesthesia students in providing individualized Anesthesia clinical care using an
individualized Anesthesia management plan
 Equip Anesthesia students on the management of patients with multiple Co-existing diseases
using the existing scientific knowledge
 Enable Anesthesia students to practice professionally on all levels of Anesthesia clinical care
setting
 Train Anesthesia students in developing professional communication skills in dealing with
patients, patient families, and other health professionals
 Prepare the Anesthesia students to participate in conducting and utilizing relevant research
findings
 Train Anesthesia students to apply evidence-based Anesthesia clinical care practice
 Train the Anesthesia student in practical skills based on a theoretical foundation
 Equip the Anesthesia students with leadership and management skills
 Equip Anesthesia students with critical thinking and decision-making skills which lead to
reflective and responsible practice
 Equip Anesthesia students with knowledge and skill in emergency and critical care which
help them to handle critically ill patients
 Prepare Anesthesia students for post-graduate studies

Themes and list of modules/courses with Credit Hours

Table 1: List the themes and courses with credit hours from the core competency identified

List of Themes List of modules/courses Cr. Hrs

Preoperative and Postoperative assessment and care 3

Airway Management 3
Obstetrics and Gynecologic Anesthesia 7

Neonatal and Pediatrics Anesthesia 6

Geriatrics Anesthesia 3
Patient care Anesthesia for General, Urologic and thoracic emergency 7
Surgeries
Anesthesia for Trauma and Orthopedics Surgeries 5
Anesthesia for Neurosurgery 4
Anesthesia for EENT and Maxillofacial surgery 4
Pharmacology for Anesthetists 4
Anesthesia for Patients with Coexisting disease 4
Regional Anesthesia and Pain management 3
Emergency and Critical Care 3
Professionalism Introduction to Anesthesia II 3
and Ethics

5
 List of Themes List of modules/courses Cr. Hrs

Leadership and management 3

Leadership and
management

Research Methods, Evidence Based Medicine and Clinical Audit 3

Education,
Research and
Evidence based
Practice

Health Health promotion and disease prevention 4

promotion and
disease
prevention

Share of the Themes/Courses/Items in Percentage (%)

a
• Share of themes (T) = x 100 ,Where “a” is the credit hour of a theme and “b” is
b
the total credit hour of the program. Credit hour of a theme is the sum of credit
hours of courses in the theme.
Credit hour of the course
• Share of courses per theme (C) = x 100
Credit hour of the theme
• Share of items per course = Share of thecourse X Total number of items
• knowledge, skill and attitude

6
Table 2: calculation of weight and number of items for each courses and learning outcomes
Themes Course Name Cr. Weigh Number Cognitive
Hr. t of of test

Psychomotor
course items

Understand
Remember
outcomes

Affective
Learning

Evaluate
from

Analyze

Create
Apply

Total
each
course
Theme  Preoperative  Perform comprehensive pre- 3 3/56 = 0.053 * - 1 3 0.5 - - - - 4.5
One: postoperative anesthetic patient assessment 0.053 85 = 4.5
Patient assessment and  Determine the clinical status of a
Care (85%) care patient
 Obtain informed consent
 Prepare patients for Anesthesia
and surgery
 Optimize patients for surgery and
Anesthesia
 Check and prepare the post-
Anesthesia care units and
standards
 Handover patient to respective
unit postoperatively
 Manage patients at PACU
 Airway  Check & prepare airway 3 3/56= 0.053 * - 2 2 0.5 4.5
management equipment 0.053 85 = 4.5
 Assess patients’ airways
 Manage patients’ airways using
basic airway management
techniques
 Manage patients’ airways using
advanced airway management
modalities
 Obstetrics and  Provide perioperative anesthetic 7 7/56 = 0.125 * - 3 5 1 1 0.6 - - 10.6
gynecologic care for obstetrics surgical clients 0.125 85 =
7
 Anesthesia  Provide perioperative anesthetic 10.6
care for gynecologic surgical
patients
 Manage Anesthesia related
complications during obstetrics
and gynecologic surgeries
 Neonatal and  Manage perioperative anesthesia 6 6/56 = 0.107 * - - 6 2 1 - - - 9
Pediatric for pediatrics and newborns 0.107 85 = 9.1
Anesthesia  Manage complications related
with Anesthesia during pediatric
and neonatal surgeries
 Perform neonatal resuscitation
 Geriatrics  Provide anesthesia for geriatrics 3 3/56 = 0.053 * - 2 3 .5 4.5
Anesthesia patients 0.053 85 = 4.5
 Manage Anesthesia related
complications for geriatric
patients undergoing surgeries
 Anesthesia for  Manage Anesthesia for different 7 7/56 = 0.125 * - 3 5 1.5 1 10.6
General, urologic general and urologic emergency 0.125 85 =
and thoracic surgical procedures 10.6
Emergencies  Manage Anesthesia for
emergency thoracic surgeries
 Anesthesia for  Manage Anesthesia for trauma, 5 5/56 = 0.089 * - 2 4 1 0.5 7.5
Trauma and orthopedic surgeries and burn 0.089 85 = 7.5
Orthopedics  Manage patients with different
types of shock
 Anesthesia for  Manage Anesthesia for 4 4/56 0.071 * - 2 3 1 6
Neurosurgery neurosurgeries =0.07 85= 6
1
 Anesthesia for  Manage Anesthesia for 4 4/56 = 0.071 * - 2 3 1 6
EENT and maxillofacial and ENT surgeries 0.071 85= 6
Maxillofacial
Surgery
8
 Pharmacology for  Select and administer 4 4/56 = 0.071 * - 2 3 1 6
Anesthetists appropriate anesthetic 0.071 85= 6
drugs; adjuvants, and other
classes of drugs used in
Anesthesia practices

 Anesthesia for  Manage Anesthesia for patients 4 4/56 = 0.071 * - 2 3 1 6

Patients with with common co-existing 0.071 85= 6
Coexisting disorders
diseases
 Regional  Manage regional Anesthesia 3 3/56= 0.053 * - 2 2 .5 4.5
Anesthesia &  Assess acute and chronic pain 0.053 85 = 4.5
pain management  Manage acute pain
 Participate in the management of
chronic and cancer pain

 Emergency and  Engage in the initial assessment 3 3/56= 0.053 * - 2 2 .5 4.5

critical care and stabilization of critically ill 0.053 85 =
patients during out-of-hospital 4.52
care and transport
 . Assess emergency and critically
ill patients who need immediate
attention
 Engage in the management of
emergency patients who need
immediate attention at the
emergency department
 Engage in the management of
critically ill patients who are
admitted to the ICU
 Recognize critically ill patients
early before cardiac arrest
happens
9
  Perform effective Basic Life
Support
 Perform effective Advanced Life
Support
 Provide post-resuscitation care
for patients who achieve the
return of spontaneous circulation
(ROSC)
Theme one total credit 56 85 85
Theme 1. Introduction to  Apply standard safety measures 3 3/3 = 1 * 8 = 8 - 1 2 2 2 1 - 8
Two: Anesthesia II to manage perioperative hazards 1
Professiona  Prepare & utilize medical gas
lism & sources/ supplies according to
Ethics acceptable practice standards and
(8%) protocols
 Prepare and utilize Anesthesia
machines safely
 Apply and utilize standard patient
monitoring
 Utilize ancillary anesthetic
equipment & materials
 Apply ethical and legal principles
to Anesthesia practice
 Practice within the standard and
scope of Anesthesia practice
 Communicate effectively with
patient, patient family &
multidisciplinary team
 Produce and maintain complete
and accurate Anesthesia
documentation

Theme two total credit 3 8

10
Theme 1. Research  Conduct research relevant to peri- 3 3/3 = 1 * 2.5 = - 1 1 0.5 - - - 2.5
Three: methods, operative medicine and critical 1 2.5
Education, evidence based care
research, medicine and  Apply the principles of evidence-
and EBP Clinical audit based practice
(2.5%)  Conduct a clinical audit and need
assessment
Theme three total 3 2.5
credit
Theme 1. Leadership and  Plan Anesthesia service activities 3 3/3 = 1 * 3 = 3 - 2 1 3
four: management  Implement Anesthesia service 1
Leadership activities
and  Monitor the overall Anesthesia
manageme service plan in a facility
nt (3%)  Report Anesthesia service
deliveries (including risks and
incidents)
 Adapt and implement a quality
improvement and assurance
framework for quality Anesthesia
service delivery
Theme four total 3 3
credit
Theme 1. Health promotion  Asses and diagnose community 4 4/4 = 1 * 1.5 = - 1 0.5 1.5
five: and disease health problems 1 1.5
Health prevention  Create community awareness on
promotion topics relevant to Anesthesia
and disease practice (including community
prevention education)
(1.5%)  Implement infection prevention
and control protocols
Theme five total 4 1.5
credit
11
Total for the program 69 100
Note: The number of items assigned in the levels of domains is based on the nature of learning outcomes/objectives

12
 Test blueprint Table (Table of Specification)
Table 3: Test blueprint framed using themes/domains, competencies and learning outcomes with the hierarchy of learning

Sha Course/sub- Cr. Competencies

re competency Hr. Knowledge
of

Creation/Synthesis
Competencies

No. of items
Themes/ the

Understanding
Remembering
(share of Assessment objectives

Application

Evaluation
Domain the

Analysis

Skill
Competency)
mes
in
%

Patient care 85% Assess, Pre-operative 3 AO1: Identify the relevant pre-anesthetic history to - 4 7 2 - - 15
optimize, and Postoperative Anesthesia and surgery
prepare Assessment AO2: Determine relevant physical examination to
patients for and Care Anesthesia and surgery
Anesthesia AO3: Choose relevant laboratory and diagnostic
and surgery investigations as per patient indication
(15%) AO4: Interpret laboratory findings & imaging relevant
to Anesthesia
AO5: Select routine medications and anesthetic agents
AO6: Score and stratify patient clinical status 1 1
AO7: Decide patient fitness for Anesthesia
AO8: Explain components of an Anesthesia
management plan based on pre-anesthetic assessment
findings
AO9: Revise components of informed consent
AO10: Explain appropriate information to be offered
to patients on the anesthetic management plan

1
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO11: Check comprehension of patients, patient
families, and other legal body
AO12: Calculate intravenous fluid requirement based
on patient conditions
AO13: Differentiate intravenous fluids with their
compositions
AO14: Identify the right dose and concentration of
emergency drugs required for the provision of safe
Anesthesia
AO15: Decide patient-specific fasting guidelines
AO16: Select appropriate premedication drugs as per
the health status of the surgical patient
AO17: Analyze the principles of patient and family
counseling and education
AO18: Justify preoperative cessation of smoking
guidelines for Surgical patients
AO19: Decide preoperative drug discontinuation/
continuation that is relevant to Anesthesia and surgery.
Prepare & Basics of 3 AO1: Recognize the possible hazards that happen in 4 7 2 1 1 1 1 17
utilize Anesthesia Anesthesia practice
Anesthesia AO2: Propose strategies to minimize professional
machines, hazards of Anesthesia including operating room
equipment, pollution
supply, and AO3: Apply the principle of infection prevention

2
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in monitoring AO4: Apply measures to reduce position and
devices (17%) procedure-related injuries
AO4: Apply measures to reduce surgical error and
patient harm
AO5: Explain mechanisms to check the availability,
functionality, and connection of medical gas sources
AO6: Differentiate medical gas sources
AO7: Identify types of medical gases
AO8: Outline troubleshooting mechanisms for
pipeline, cylinders and Anesthesia machine
AO9: Recognize different parts of the Anesthesia
machine
AO10: Analyze routine Anesthesia machine
functionality test steps
AO11: Solve routine Anesthesia machine malfunction
AO12: Justify standards of patient monitoring
AO13: Interpret common findings from standards
patient monitoring (Pulseoxymetery & ETCO2)
AO14: Interpret 12 lead ECG
AO15: Select airway equipment for different age
groups and procedure
AO16: Select ancillary equipment used in the
management of difficult airway
AO17: Select appropriate anesthetic breathing systems

3
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO18: Outline safe utilization principles of a
defibrillator for shockable cardiac arrest rhythms
Manage Airway 3 AO1: Interpret different airway examination findings - 4 4 1 1 12
patients’ Management AO2: Identify patients with difficult airways using
airways using relevant history
different AO3: Propose airway management plan
modalities AO4: Suggest airway maneuvers
(12%) AO5: Evaluate the effectiveness of bag-mask
ventilation
AO6: Justify the use of airways (oral & 1 1
nasopharyngeal)
AO7: Utilize supraglottic devices (SGDs) LMAs,
AO8: Rationalize the use of endotracheal intubation
(nasal and oral)
AO9: Plan other alternative measures between airway
management attempts
AO10: Outline management plan for patients with
difficult airways according to acceptable guidelines
(DAS/ASA)
AO11: Recognize the need for consultation for further
airway management
AO12: Identify extubation criteria
AO13: Devise management plan for common airway
complications

4
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in Manage safe Obstetrics & 50 AO1: Justify the effect of different anatomic changes 1 5.5 7 3 3 1 22.
Anesthesia Gynecologic of pregnancy on the intraoperative anesthetic 5
(22.5) Anesthesia, management
Neonatal AO2: Justify the effect of different physiologic
&Pediatrics changes of pregnancy on the intraoperative anesthetic 1
Anesthesia, management
Geriatric AO3: Formulate Anesthesia management plan for
Anesthesia clients undergoing obstetrics surgery
General & AO4: Develop Anesthesia management options for
urologic patients undergoing gynecologic surgery
surgery AO5: Outline management plan for intraoperative
Anesthesia, complications during obstetrics and gynecologic
Trauma & surgery
orthopedic AO6: Recognize neonates in need of resuscitation n
Anesthesia, AO7: Propose Anesthesia management options for
Neurosurgery high-risk pregnancy
Anesthesia, AO8: Choose Anesthesia management for a pregnant
Thoracic woman coming for non-obstetric surgery
emergency AO9: Explain the anesthetic implication of the
Anesthesia, anatomic differences between children and adults
Naxillofacial AO10: Explain the anesthetic implication of
and ENT physiological and psychological differences between
Anesthesia, children and adults
Ophthalmic AO11: Explain the anesthetic implication of the

5
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in Anesthesia, pharmacological differences between children and
Pharmacology adults
for AO12: Devise intraoperative Anesthesia management
Anesthetists, for common pediatrics and neonatal emergency
Anesthesia for surgeries
coexisting AO13: Formulate management plan for common
diseases intraoperative complications during pediatrics and
neonatal emergency surgeries
AO14: Plan Anesthesia for pediatrics and neonate with
common comorbidities
AO15: Analyze the implications of aging on
Anesthesia management
AO16: Select appropriate anesthetic drugs and
techniques for geriatric patients undergoing surgery
AO17: Plan intraoperative Anesthesia care for geriatric
patients
AO18: Propose management plan for common intra-
operative complications for geriatrics
AO19: Apply different components of ERAS for
Anesthesia management
AO20: Predict the effects of different anesthetic drugs
on body systems
AO21: Select appropriate anesthetic drugs and
techniques for common general and urology surgery

6
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO22: Outline management options for common intra-
operative complications during general and urology
surgery
AO23: Plan management for different types of shock
AO24: Plan intra-operative Anesthesia management
for trauma and orthopedic surgery
AO25: Propose management plan for intraoperative
complications during orthopedic and trauma patients
AO26: Apply principles of damage control
resuscitative surgery
AO27: Outline Anesthesia management plan for a
patient with burn
AO28: Choose fluid, electrolyte and blood products
AO29: Analyze fluid management considerations for
neurosurgeries
AO30: Explain the effect of different neurosurgical
positioning in anesthetic management
AO31: Identify management principles for raised ICP
AO32: Plan Anesthesia care for neurosurgeries
AO33: Justify management plan for intraoperative
complications during neurosurgeries
AO34: Propose Anesthesia management plan for head
injury patients
AO35: Select the appropriate anesthetic drugs and

7
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in techniques for patients undergoing emergency thoracic
surgery
AO36: Differentiate common intraoperative
complications during thoracic surgery
AO37: Recognize the effects of positioning and
Anesthesia on respiratory mechanics
AO38: Justify indications for lung isolation
AO39: Outline Anesthesia management plan for one-
lung ventilation
AO40: Identify intraoperative complications during
thoracic surgery
AO41: Plan intra-operative anesthetic care for
maxillofacial and ENT surgery
AO42: Identify challenges specific to maxillofacial
and ENT surgeries
AO43: Develop management plan for complications
specific to maxillofacial and ENT surgeries
AO44: Analyze the interaction between ophthalmic
medications and anesthetic agents and adjuvants
AO45: Explain management principles for raised IOP
AO46: Plan intra-operative Anesthesia care for
ophthalmic surgery
AO47: Outline intraoperative Anesthesia management
plan of patients undergoing emergency ophthalmic

8
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in surgery
AO48: Identify intraoperative complications of
patients undergoing ophthalmic surgery
AO49: Justify day-case patient selection protocols
AO50: Select appropriate anesthetic drugs and
techniques for day-case patient management
AO51: Outline discharge criteria for day-case surgical
patients
AO52: Identify peculiar challenges and safety risks
associated with remote Anesthesia
AO53: Devise management plan for complications
during remote Anesthesia
AO54: Identify relevant anatomical landmarks for
regional Anesthesia
AO55: Decide patient fitness for regional Anesthesia
(Indication/ contraindication)
AO56: Identify relevant equipment and material for
regional nerve blocks
AO57: Evaluate the required volume, dosage, and
concentrations of local anesthetics and adjuvants for
regional Anesthesia
AO58: Explain techniques for spinal Anesthesia
AO59: Explain techniques for peripheral nerve blocks
AO60: Determine the effectiveness of block

9
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO61: Propose management options for intraoperative
complications during regional Anesthesia
AO62: Justify the impact of comorbidities on
Anesthesia management and patient outcome
AO63: Diagnose patients with common co-morbid
conditions before Anesthesia and surgery
AO64: Suggest optimization plan for patients with
common co-morbid conditions before Anesthesia and
surgery
AO65: Select appropriate drugs and techniques for
patients with common co-morbidity
AO66: Plan intra-operative Anesthesia care technique
for patients with a common co-morbid condition
AO67: Identify common complications of patients
with common co-morbid conditions during Anesthesia
and surgery
Provide Preoperative 3 AO1: Recognize components of postoperative care - 2 2 1 1 6
postoperative and AO2: Develop a postoperative management plan
anesthetic care Postoperative AO3: Critique the design and staffing of the PACU
(6%) Assessment AO4: Decide patient admission and discharge to and
and care from PACU
AO5: Propose appropriate transfer of care and
responsibility during the handover of patients
AO6: Assess the patient’s status on arrival at PACU

10
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO7: Plan postoperative care during patient
transportation from OR
AO8: Diagnose common postoperative complications
of the surgical patient admitted to PACU
AO9: Stratify patient condition using different risk
scoring and stratification methods
AO10: Devise management plan for common
postoperative complications
AO11: Recognize the need for consultation in PACU
Manage pain Regional 3 AO1: Identify essential components of history for
for different Anesthesia patients with pain
patient groups and Pain AO2: Rate pain using different pain rating scales
(3.5) Management AO3: Recognize the impact of pain on different body
systems
AO4: Recognize pain pathway
AO5: Devise a pain management plan using the WHO
analgesic ladder

0.6

1.6
AO6: Recognize patients with pain
AO7: Measure the effectiveness of pain management
regularly
AO8: Recognize complications related to pain
management modalities and drugs
AO9: Propose management plan for complications
related to pain management modalities and drugs

3.5
11
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO10: Recognize the role of psychological, social,
rehabilitation, and other support services
AO11: Identify common types of chronic pain 0 0
syndromes . .
Engage in pre- Emergency 1.5 AO1: Recognize critically ill patients - 2 61 0. 6 3.5
hospital, medicine and AO2: Recognize risks associated with patient transfer 5
emergency, Critical Care (physical, psychological, and organizational)
and critical AO3: Evaluate the condition of patients during
care services transportation
(3.5%) AO4: Apply different stabilization techniques during
the transport of a critically ill patient
AO5: Apply special precautions during the transfer
and intubation of trauma patients
AO6: Recognize problems encountered during
retrieval of victims from the scene
AO7: Explain the national Early Warning score
AO8: Recognize the goals of initial assessment and
monitoring of critically ill patients
AO9: Identify danger (warning) signs in critically ill
patients
AO10: Identify indications for endotracheal intubation
of critically ill patients
AO11: Apply principles of the primary survey
AO12: Apply principles of a secondary survey during

12
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in patient assessments
AO13: Recognize special considerations during the
management of pediatric and obstetric critically ill
patients
AO14: Recognize the need for a multi-disciplinary
team during the management of emergency and
critically ill patients
AO15: Identify common causes of respiratory failure
AO16: Recognize patients’ admission and discharge
criteria to & from ICU
AO17: Recognize indication and principles of
mechanical ventilation in ICU
AO18: Plan electrolyte and acid-base disturbance
management
AO19: Apply ABCDE approaches to Manage
immediate life-threatening conditions)
AO20: Select different settings of ventilation
according to the indication
Perform AO1: Analyze the setting to manage critically ill - 1 1 0. 1 1 1 5.5
cardiopulmon patients 5
ary AO2: Assess critically ill patients regularly using
resuscitation ABCDE
(CPR) (5.5%) AO3: Differentiate patients who need urgent responses
AO4: Recognize reversible causes of cardiac arrest

13
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO5: Recognize the importance of high-quality CPR
and its impact on survival
AO6: Propose management plan for Airway
Obstruction
AO7: Plan effective ventilation strategies by using a
barrier device
AO8: Justify the effectiveness of chest compression
AO9: Propose defibrillation using AED
AO10: Suggest advanced airway management
modalities during life-threatening airway obstructions
AO11: Plan management option for patients with
respiratory arrest using artificial ventilation
AO12: Diagnose cardiac arrest
AO13: Develop pharmacological and electrical
interventions plan for cardiac arrest
AO14: Recognize the role of the multi-disciplinary
team during post-resuscitation care
AO15: Develop essential post-resuscitation care
AO16: Recognize the need for appropriate
documentation throughout the peri-arrest period
Professionalis Uphold the Introduction to 3 AO1: Justify the applicability of ethical principles in 1 1 8
m and ethics Anesthesia Anesthesia II Anesthesia practice
8% AO2: Solve ethical dilemmas and uncertainties - 2 3 1
practice
standard and AO3: Analyze ethical Anesthesia practice during

14
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in interactions with patients and their families/ attendants
and colleagues.
AO4: Apply different principles to resolve the ethical
dilemma
AO5: Recognize the role of law in Anesthesia practice
AO6: Recognize the rights, interests, and needs of
patients and their family
AO7: Apply codes of ethics in the practice of
Anesthesia per the national guideline
AO8: Rationalize the need to practice within the
defined scope of professional requirements
AO9: Recognize the consequence of breaching the
ethics and be defined scope of practice
accountable to AO10: Comply with the standard of practice
the public and AO11: Identify acute events and complication
the profession strategies with the surgical team
(8%) AO12: Recognize the communication model and
process
AO13: Propose safe, effective, and consistent
communication with a multidisciplinary team
AO14: Plan safe, effective, and consistent
communication with a patient
AO15: Recognize the need for appropriate Anesthesia
documentation

15
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
Education, in Research AO1: Justify the application of research in Anesthesia 2.5
research, and method, practice
EBP Clinical Audit AO2: Distinguish the commonly used research designs
and Evidence AO3: Determine sample & sampling methods
based Practice
AO4: Identify appropriate research objectives
Demonstrate (2.5%)
2.5 AO5: Justify Ethical principles in research
commitment
% to excellence AO6: Recognize the need for evidence-based practice
in Anesthesia AO7: Recommend credible online resources for
practice Anesthesia practice
through the AO8: Compare different sources of information - 1 1 .5
application of AO9: Appraise published articles critically
evidence to AO10: Recognize critically appraised literature
practice and
AO11: Justify the relevance of clinical audit in
research
Anesthesia practice
activities
AO12: Outline audit cycle
AO13: Explain performance standards of practice
AO14: Choose appropriate audit methodologies
AO15: Outline dissemination strategies of clinical
audit findings
Leadership and Manage Leadership AO1: Assess workplace, health, and safety for patients 1 3
management Anesthesia and 3 and staff (eg: AFAT) - 1 1
service in a Management AO2: Develop Anesthesia service work plan

16
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in (3%) AO3: Prioritize short- and long-term plans for the
service in consultation with multidisciplinary team
members

AO4: Propose appropriate technology and

standardized practices that support safe practice
health facility
AO5: Formulate appropriate and corrective measures
to solve problems encountered

AO6: Develop management plan of conflicts with

patients and multidisciplinary team

AO7: Evaluate resource utilization as per the plan and

organizational policy

AO8: Examine the quality of service using key

performance indicators

AO9: Develop Anesthesia service reports

AO10: Analyze report findings to improve Anesthesia

practice

AO11: Identify Anesthesia service standards

AO12: Formulate strategies for the delivery of high-

17
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in quality Anesthesia service.

AO13: Recognize the importance of regular

discussions with surgical team members

Health 1.5 Health AO1: Assess community health problems 0.5 1 1.5
promotion and % promotion and
disease Asses and disease AO2: Prioritize community health problems in
prevention diagnose prevention relevance to Anesthesia
community
AO3: Recognize national priority diseases and control
health
program
problems
(0.5%) 1.5%
AO4: Analyze community needs assessment to
provide surgical, Anesthesia, and critical care

Plan and AO1: Formulate health education strategies in various

implement contexts/settings
health
promotion A02: Develop means for awareness creation of the
and disease Anesthesia profession to the patient
prevention
AO3: Explain healthy lifestyles (diet, exercise) and
interventions
behaviors for risk reduction
(1%)
AO4: Apply infection prevention and control strategies

18
 Sha Course/sub- Cr. Competencies
re Competencies competency Hr. Knowledge

No. of items
Themes/ of (share of Assessment objectives

Understan

Applicatio
Remembe

Evaluatio

Creation/
Domain

Analysis

Skill
the Competency)

ding
the
mes
in AO5: Plan for awareness creation of infection
prevention and control (IPC) measures

Learning outcomes in terms of the three domains (Cognitive, Affective and Psychomotor)
Share of Share of Competencies (in %)
S/N Themes Course Name Cr. Hrs Remark
Courses (%) Knowledge Skill Attitude
1 Patient Care Preoperative and 3 4.5 3 1 0.5
Postoperative assessment and
care
Airway Management 3 4.5 3 1 0.5
Obstetrics and Gynecologic 7 10.6 7 3 0.6
Anesthesia
Neonatal and Pediatrics 6 9.1 7 1 1
Anesthesia
Geriatrics Anesthesia 3 4.5 3 1 0.5
Anesthesia for General, 7 10.6 7 3 1
Urologic and thoracic

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 emergency Surgeries
Anesthesia for Trauma and 5 7.5 6 1 0.5
Orthopedics Surgeries
Anesthesia for Neurosurgery 4 6 4 1 1
Anesthesia for EENT and 4 6 4 1 1
Maxillofacial surgery
Pharmacology for 4 6 4 1 1
Anesthetists
Anesthesia for Patients with 4 6 4 1 1
Coexisting disease
Regional Anesthesia and Pain 3 4.5 3 1 0.5
management
Emergency and Critical Care 3 4.5 3 1 0.5
2 Professionalis Introduction to Anesthesia II 3 4.5 3 1 0.5
m and Ethics
3 Education, Research methods, Evidence 3 4.5 3 1 0.5
Research and Based Practice and Clinical
Evidence Audit
based Practice
4 Leadership Leadership and Management 3 4.5 3 1 0.5
and
Management
5 Health Health Promotion and 4 6 4 1 1
Promotion and Disease Prevention
Disease
Prevention
Total (Aggregate) 100 71 21 13

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Conclusion
Exit examination can have a vital role in producing knowledgeable, skillful and attitudinally matured graduates. It
contributes to prepare competent graduates as it can serve as a quality check for effectiveness. It also helps in
improving academic programs quality and effectiveness. Furthermore, it can create the platform for cooperation
among academic programs at different universities to work jointly to improve the programs quality.

To meet the graduation profile, competency and learning outcome, exit exam competency selection and identifying
core course was done for 2015 EC graduating students. As a result, preparing test blueprint is necessary to prepare
fairly distributed items based on the above criteria. In view of this, this document is produced to assist the setting of
the exit examinations for Anesthesia program, which is being delivered by Ministry of Education.

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