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The Educational Prescription in Postgraduate Assessment

The Educational Prescription in Postgraduate Assessment. An assessment for GPs wishing to return to clinical practice in London. Anwar Khan, Penny Trafford, Peter Burrows, Neil Jackson. Background. A shortage of GPs in London due to: •  Retirement, flexible careers,

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The Educational Prescription in Postgraduate Assessment

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  1. The Educational Prescription in Postgraduate Assessment An assessment for GPs wishing to return to clinical practice in London Anwar Khan, Penny Trafford, Peter Burrows, Neil Jackson Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  2. Background A shortage of GPs in London due to: •  Retirement, flexible careers, •  Shortfall in recruitment and training, •  Expansion of services (NHS plan 2000). Department of Health stopped GP Returner funding in 2005 Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  3. Issues • Doctors entitled to work but: • Most Primary Care Organisations (PCO) will not admit to ‘performer’s list’ when .. • UK Returners - time out >3 years • EU GPs – relocation and hence no UK Primary Care experience. • Performance Unit clients (PU) – PCT/GMC involvement • Learning need recognised by • Individual doctors – decreasing clinical skills and knowledge over time • Deanery – educational need due to changes in NHS • PCOs require quality assurance of competence for safe and independent practice in NHS Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  4. Induction Course • 3-6 month full-time equivalent (FTE) programme • Duration dependent on the “educational prescription” • Attachment to practice with mentor • Supervised consultations and tutorials • Half-day release course with tutor, peer group support and self-directed learning Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  5. Entry Assessment Prior to induction course: • Multiple choice paper: Clinical knowledge • need to pass to progress to next stage • Simulated surgery (OSCE): Consultation skills and clinical problem solving Summative – minimum scores for entry Formative – identifying learning needs for educational prescription Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  6. Exit Assessment On completion of induction course: • NHS logbook – evidence of formative workplace based learning • Simulated surgery (OSCE) – Consultation skills and clinical problem solving Summative – successful completion can be used by PCT for decision re: inclusion on the ‘performers’ list Formative – confirms candidate’s progress and instils confidence Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  7. Simulated Surgery (OSCE) • Circuit of ten stations • Common primary care presentations • 10-minute consultations • Simulated patients • Assessed by observer • Language observer as appropriate Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  8. Marking • Case specific marking schedules • Each case marked in five domains • Gathering medical information • Eliciting the patient’s concerns • Explaining the diagnosis • Managing the problem • Closing the consultation • Passing scores are set for • Entry to the induction course • Exit and information to the PCT Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  9. Marking: case specific Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  10. Marking: domain specific Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  11. Formative feedback • After each consultation, brief comments about the doctor’s performance are recorded by the observer and the role-player • These are compiled so that each candidate receives a sheet with feedback from 10 role-players and 10 observers • Feedback to be positive and/or constructive with suggestions for improvement. Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  12. Educational prescription • On completion of OSCE, each candidate has individual feedback from an observer • Presented with personal score sheet • Significance of results explained • Discuss strengths and weaknesses • Discuss feedback from observers/ role-players • Learning needs agreed • During practice placement mentor uses educational prescription to plan the mentee’s learning/PDP Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  13. Applications 2003-2008 Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  14. MCQ results (%) Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  15. OSCE results (%) Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  16. Outcomes of the programme Drs Penny Trafford and Anwar Khan - Prague Aug 2008

  17. Conclusions • Educational prescription given to those doctors who pass the summative entry assessments • Minimum entry requirements to ensure safe clinical care during the placement • Individualised educational prescription provides formative guidance during the placement promoting adult learning • The NHS logbook provides the evidence of the practitioner’s development in compliance with the educational prescription Drs Penny Trafford and Anwar Khan - Prague Aug 2008

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