Transcript nMRCGP

nMRCGP
Please remember the final format is not set and
this presentation was in March 2007
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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
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Neither summative assessment nor the MRCGP
exam has a robust assessment of clinical skills
Both focus on assessing communication skills in
the consultation, not overall clinical competency
Two tiered system of summative assessment and
the MRCGP exam was proving too cumbersome.
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 hurdles
Opportunities for remedial support for any struggling
trainees.
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)
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How to become a GP
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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:
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Applied Knowledge Test (AKT),
 Clinical Skills Assessment (CSA)
 Workplace-Based assessment
(WPBA).
Applied Knowledge Test
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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 skills
2. Clinical management skills
3. Interpersonal skills
Workplace-based
Assessment
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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
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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.
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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 Entries
Clinical encounters, tutorials, reading,
lectures, seminars, professional
conversations and more.
Personal Development Plan
A dynamic record of training needs
Assessments
Progress to Certification
Information 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
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