nmrcgp please remember the final format is not set and this presentation was in march 2007
TRANSCRIPT
nMRCGP
Please remember the final format is not set and this presentation was in March 2007
PMETB
The establishment of the Postgraduate Medical Education Training Board (PMETB) has led all royal colleges to review their curriculi and appraise their assessments against PMETB principles
At the same time, Modernising Medical Careers introduced a competency based curriculum
for the foundation year programme. This highlighted
the need for more flexible formative career progression which avoids tying trainees to
rigid summative examinations.
changing philosophy of assessment
Increased emphasis on performance in the workplace
Rational
1. Neither summative assessment nor the MRCGP exam has a robust assessment of clinical skills
2. Both focus on assessing communication skills in the consultation, not overall clinical competency
3. Two tiered system of summative assessment and the MRCGP exam was proving too cumbersome.
4. The multiple assessment hurdles impacted detrimentally on the educational agenda
The trainees asked for
A robust assessment package worthy of effort
An educationally focused, effectively delivered trainer's report
Fair, reliable, and relevant examinations
Fewer summative hurdles
Developments mindful of costs.
The lay representatives asked for:
Appropriate, reliable standards for completion of training
Assurance registrars will be safe for independent practice
Lay involvement in standard setting
A clinical skills test.
The educators asked for:
More time to teach
Less assessment
A single route process
Formative approaches
Flexible career progression
Avoidance of multiple workplace assessment hurdlesOpportunities for remedial support for any strugglingtrainees.
The assessors asked for
Assessments which drove the education agenda
Content reflective of real practice
Continuing high standards for assessor selection and training
Maintenance of a national panel of assessors
Fairness and equal opportunities for trainees and assessors
PMETB standards require that the assessments are designed to
"confirm suitability of choice at an early stage of chosen career
path." A single, national UK assessment centre based
selection process into vocational training is being established by
the deaneries.
Standards
They will be at a level appropriate to exit from vocational training that assures the public that registrars are safe and "fit for purpose" to practise independently.
New standard to be set by the PMETB on the recommendation of the RCGP.
From August 2007 there will be a single training and
assessment system for UK trained doctors wishing to
obtain a CCT (Certificate of Completion of Training) in
General Practice.
Certification unit
It is recommended that those training for General Practice register with the Certification Unit as soon as they begin the CCT programme ( £350)
The RCGP ’s Certification Unit has functional responsibility for processing applications for certification as a General Practitioner (£250)
How to become a GP
An online application A two-part assessment involving a Multiple
Choice assessment of clinical competence and a handwritten short question paper
Successful candidates are asked to attend further selection assessment
Allocation and offer No mention re those that are not successful.
The nMRCGP is an integrated assessment programme that includes three components:
Applied Knowledge Test (AKT), Clinical Skills Assessment (CSA) Workplace-Based assessment
(WPBA).
Applied Knowledge Test
The applied knowledge test is a summative assessment of the knowledge base that underpins independent general practice within the united kingdom.
The test will take the form of a three hour 200 item multiple-choice test
The AKT will be delivered using computer terminals at 147 Pearson Vue professional testing centres around the UK.
Approximately 80% of question items will be on
clinical medicine, 10% on critical appraisal and
evidence based clinical practice
10% on health informatics and administrative issues.
On three days each year candidates will be able to sit
the AKT at one of the Pearson Vue centres.
Candidates registered for the nMRCGP will call Pearson
Vue to book a test and choose a centre. The earlier
a candidate books, the greater the chances of their
preferred centre being available:
Clinical Skills Assessment
The Clinical Skills Assessment (CSA) is‘an assessment of a doctor’s ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice’.
This component of the nMRCGP will be available from October 2007. The
assessment will be available during a 3 or 4 week period in
sessions in February, May and October each year. It will
take place in one location
Each candidate will be given a consulting room and will have appointments with 13
patients, each lasting around 10 minutes.
The performance will be graded as -Clear Pass,
Marginal Pass, Marginal Fail
Clear Fail.
Example scenarios showing the nature of this assessment
nMRCGP - A guide to the Clinical Skills Assessment DVD
Wessex Faculty RCGP
The CSA will test mainly from the following areas of the
curriculum:1. Data gathering, technical
and assessment skills2. Clinical management skills
3. Interpersonal skills
Workplace-based Assessment
WPBA for nMRCGP is defined as the evaluation of a doctor’s progress in their performance over time, in those areas of professional practice best tested in the workplace.
Longitudinal process
Twelve areas of professional competence have been extracted from the core
curriculum statement ‘Being a General Practitioner’.
*Communication and Consultation Skills*Practising Holistically*Data Gathering and Interpretation*Making a Diagnosis/Making Decisions*Clinical Management*Managing Medical Complexity
Primary Care Administration and Information Management and Technology
Working with Colleagues and in Teams Community Orientation
Maintaining Performance, Learning and Teaching
Maintaining an Ethical Approach to Practise
Fitness to Practise
Deanery
Will moderate the GP trainers. Will review all evidence Will collate externally moderated
assessments.
The e-Portfolio
The evidence for WPBA will be recorded in a web-based e-portfolio. The e-portfolio is much more than an electronic record of specialist training, updated and accessible through the internet, it records details of achievement in the Applied Knowledge Test and Clinical Skills Assessment, and documents all stages of training, records evidence of WPBA, `reviews with educational supervisors and the subsequent development as a General Practitioner
Learning Log
Log EntriesClinical encounters, tutorials, reading, lectures, seminars, professional conversations and more.
Personal Development PlanA dynamic record of training needs
Assessments
Progress to CertificationInformation on CCT, chart summarizing progress, declarations and more.
Applied Knowledge Test (AKT)Information on AKT, how to book a test and record of result.
Clinical Skills Assessment (CSA)Information on CSA, online application and record of result.
Workplace-based Assessment (WPBA)Information on WPBA, professional competencies, DOPS, CBD, MSF, PSQ, CSR, mini-CEX, COT.
Is it me?
WPBA (Workplace based assessment) AKT (Applied Knowledge Test)
DOP (Direct obs. of procedure) PAT (Peer assessment tool) MSF (Multi-sourced feedback) PSQ (Patient satisfaction questionnaire) TAB (Team assessment of behaviour) Mini CEX (Clinical evaluation exercise) CBD (Case based discussion)
Or is it me?
COT CSA (Clinical skills assessment) CSR CCT
