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nMRCGP

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.

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nMRCGP

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  1. nMRCGP Please remember the final format is not set and this presentation was in March 2007

  2. PMETB The establishmentof the Postgraduate Medical Education Training Board (PMETB) has led all royal colleges to review their curriculiand appraise their assessments against PMETB principles

  3. Atthe same time, Modernising Medical Careers introduced a competencybased curriculum for the foundation year programme. This highlightedthe need for more flexible formative career progression whichavoids tying trainees to rigid summative examinations.

  4. changingphilosophy of assessment Increased emphasis on performancein the workplace

  5. Rational • Neither summative assessment nor the MRCGP exam has a robustassessment of clinical skills • Both focus on assessing communicationskills in the consultation, not overall clinical competency • Two tiered system of summative assessment and theMRCGP examwas proving too cumbersome. • The multipleassessment hurdles impacted detrimentally on theeducationalagenda

  6. The trainees asked for A robust assessment package worthy of effort An educationallyfocused, effectively delivered trainer's report Fair, reliable,and relevant examinations Fewer summative hurdles Developmentsmindful of costs.

  7. The lay representatives asked for: Appropriate, reliable standards for completion of training Assuranceregistrars will be safe for independent practice Lay involvementin standard setting A clinical skills test.

  8. The educators asked for: More time to teach Less assessment A single route process Formative approaches Flexible career progression Avoidanceof multiple workplace assessment hurdles Opportunities forremedial support for any struggling trainees.

  9. The assessors asked for Assessments which drove the education agenda Content reflectiveof real practice Continuing high standards for assessor selectionand training Maintenance of a national panel of assessors Fairness and equal opportunities for trainees and assessors

  10. PMETB standards require that the assessments are designed to"confirm suitability of choice at an early stage of chosen careerpath." A single, national UK assessment centre based selectionprocess into vocational training is being established by thedeaneries.

  11. Standards They will be at a level appropriate to exit from vocationaltraining that assures the public that registrars are safe and"fit for purpose" to practise independently. Newstandard to be set by the PMETB on the recommendation of theRCGP.

  12. 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.

  13. 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)

  14. 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.

  15. The nMRCGP is an integrated assessment programme that includes three components: • Applied Knowledge Test (AKT), • Clinical Skills Assessment (CSA) • Workplace-Based assessment (WPBA).

  16. 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. 

  17. Approximately 80% of question items will be on clinical medicine, 10% on critical appraisal and evidence based clinical practice10% on health informatics and administrative issues. 

  18. On three days each year candidates will be able to sit the AKT at one of the Pearson Vue centres. 

  19. 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:

  20. 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’. 

  21. 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

  22. Each candidate will be given a consulting room and will have appointments with 13 patients, each lasting around 10 minutes.

  23. The performance will be graded as -Clear Pass, Marginal Pass, Marginal Fail Clear Fail.

  24. Example scenarios showing the nature of this assessment nMRCGP - A guide to the Clinical Skills Assessment DVD Wessex Faculty RCGP

  25. The CSA will test mainly from the following areas of the curriculum:1. Data gathering, technical and assessment skills2. Clinical management skills3. Interpersonal skills

  26. 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

  27. Twelve areas of professional competence have been extracted from the core curriculum statement ‘Being a General Practitioner’.

  28. *Communication and Consultation Skills*Practising Holistically*Data Gathering and Interpretation*Making a Diagnosis/Making Decisions*Clinical Management*Managing Medical Complexity

  29. Primary Care Administration and Information Management and Technology • Working with Colleagues and in Teams • Community OrientationMaintaining Performance, Learning and Teaching • Maintaining an Ethical Approach to Practise • Fitness to Practise

  30. Deanery • Will moderate the GP trainers. • Will review all evidence • Will collate externally moderated assessments.

  31. 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

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