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nMRCGP Assessments on the e portfolio

nMRCGP Assessments on the e portfolio. A summary for hospital clinical supervisors Maggie Eisner June 2009. Components of nMRCGP. Applied Knowledge Test (machine marked test) – done in ST2 or ST3 Clinical Skills Assessment (simulated GP surgery) – done in ST3 in GP post

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nMRCGP Assessments on the e portfolio

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  1. nMRCGP Assessments on the e portfolio A summary for hospital clinical supervisors Maggie Eisner June 2009

  2. Components of nMRCGP • Applied Knowledge Test (machine marked test) – done in ST2 or ST3 • Clinical Skills Assessment (simulated GP surgery) – done in ST3 in GP post • Workplace Based Assessment - mini CEX (COT in GP posts), CBD, CSR, MSF, DOPS • Learning log - including clinical encounters, tutorials and seminars, significant incidents, professional conversations (etc) • All components matched to curriculum headings and to competency framework

  3. The e portfolio • Is the only record used in assessing trainee’s progress • Trainee responsible for keeping it up to date – but may need encouraging and reminding • Logon provided for Clinical Supervisor – sometimes the wrong name, e g specialty’s educational lead. Can be changed on e portfolio via VTS administrator Vicky at Field House • Clinical supervisor can view e portfolio (most of it) • Other health professionals can enter assessments via their GMC number or with electronic ‘ticket’ from trainee • Educational supervisor is GP educational supervisor for the 3 years

  4. Assessment of progress • Educational Supervisor (GP trainer or Programme Director) meets trainee twice every 6m (month 2 and 4) • At 2nd meeting, ES evaluates evidence on e portfolio and enters Educational Review • ARCP once a year (in month 10) to agree to progression from ST1 to ST2, ST2 to ST3, or grant CCT

  5. Number of assessments required before ES mtg in month 4 • DOPS – any time in training – • Mandatory (there are others) : breast exam, Cx smears, female genital exam, male genital exam, prostate exam, rectal exam, bld gluc testing, simple dressings • Observers may be SpR, staff grade, nurses, consultants • miniCEX – at least 3 per 6m • 15-min snapshot of doc-pt interaction • Observers may be staff grades, experienced SpR, consultant • MSF – 1 set of 5 per 6m in ST1, none in ST2 • CSR – at least 1 per 6m, before ES mtg in month 4 • CBD – at least 3 per 6m, preferably by experienced educator

  6. Case based discussion – what and how? • Formal, structured exercise with preparation by trainee and assessor • Developed from the old MRCGP oral exam (designed to test whether trainees could consider scenarios and issues in breadth and depth) • Intended to find evidence of specific competencies, not test knowledge • Trainee selects 2 cases, gives copies of records to assessor in advance • Assessor selects one and • decides which competencies to look at • frames questions around the actual case, not exploring hypothetical events

  7. Case based discussion – the competencies • Practising holistically • Data gathering and interpretation • Making a diagnosis/decisions • Clinical management • Managing medical complexity • Primary care admin and IMT • Working with colleagues and in teams • Community orientation • Maintaining an ethical approach • Fitness to practise

  8. Case based discussion – rating • Expect progress from NFD to competent – ‘excellent’ is a description of a mature practitioner • Insufficient evidence – if you haven’t looked at that competency, or the case doesn’t address it • Needs further devel – rigid adherence to rules, superficial grasp of facts, can’t apply knowledge, little judgement • Competent – accesses and applies knowledge, sees things in context, conscious planning, ability to prioritise • Excellent – intuitive grasp of situations, doesn’t have to rely on rules, identifies underlying principles, understands context for applying knowledge

  9. Case based discussion – making it useful • Prepare in advance • Get trainee to self rate and discuss whether you agree and why • Record a few details of the case (e portfolio has no specific slot for this, put in Feedback section) to • help educational supervisor to assess • help trainee to reflect • Encourage trainee to select case for next time which reflects the competencies they need evidence for

  10. Further information • www.bradfordvts.co.uk: nMRCGP for Consultants – Elderly medicine • www.rcgp.org.uk: GP curriculum

  11. Appendix • Detailed descriptions of the 12 competency areas and the criteria for the 4 grades • NB Each kind of assessment tests a different selection of competencies – e g CBD doesn’t include nos 1 (communication) and 9 (maintaining performance, learning and teaching)

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