No, the Prescribing Safety Assessment (PSA) is a linear, fixed-form exam, not computer-adaptive. It is a fixed set of items across defined prescribing tasks, and the difficulty does not respond to how you answer.
What the PSA format actually is
The PSA is a pass or fail assessment of prescribing skills, judgement and supporting knowledge for the NHS, aimed at final-year medical students and based on GMC competencies. It includes 60 items and is two hours in length, spanning tasks such as writing and reviewing prescriptions, dose calculations, adverse drug reactions, drug monitoring, and data interpretation. It is a fixed paper, so everyone sitting it faces the same set of tasks, unlike an adaptive test.
How the pass mark is really set
The PSA is criterion-referenced and reported as pass or fail, with the standard set to reflect safe prescribing at the level expected of a Foundation Year 1 doctor, rather than a fixed percentage or a comparison against other candidates. The standard reflects a defined competence, so the exact mark can vary while the competence bar stays constant. See how medical exam pass marks are set.
What would be different if it were adaptive
If the PSA were adaptive, it would choose each item based on your running ability and every candidate would see a different paper with difficulty rising as they did well, as in the AMC CAT, explained in how computer-adaptive testing works. The PSA is a fixed set of prescribing tasks measured against a defined standard.
How to prepare given the linear format
Because the paper is fixed, put adaptivity in your practice. Target your weak task types, especially calculations, and space your revision. iatroX's adaptive engine surfaces your weakest areas first, with free sample questions at iatroX.
Frequently asked questions
Is the PSA adaptive? No. It is a linear, fixed-form pass or fail assessment of 60 items in two hours. Difficulty does not change based on your answers.
How many items are on the PSA? 60 items over two hours, covering prescribing tasks such as writing prescriptions, dose calculations, adverse drug reactions, and data interpretation.
How is the PSA marked? As pass or fail, criterion-referenced to safe prescribing at Foundation Year 1 level, so it reflects a defined competence rather than a fixed percentage.