Enhancing GP/FM Assessment: EURACT's Role & Core Competencies

1. The Role of EURACT in developing assessment in GP / FM Dr Justin Allen

2. Current situation • Surveys by EURACT and UEMO • 15 countries reported on assessment; 11 had “final examination”, 4 had none (EURACT) • 13 countries reported; 10 had “final examination”, 3 had none (UEMO) • Vasco da Gama movement – Kos • European Directive 93/16

3. Is this a problem? • Poor data • MCQ, essay and / or oral • Examination based on curriculum • Examination set by GPs • GP examiners

4. WONCA Europe Framework • 11 Characteristics of the Discipline • Role/task description of a specialist in family medicine • Core Competencies required

5. “Core means essential to the discipline, irrespective of the health care system in which they are applied”

6. Core Competencies • 11 characteristics grouped into 6 clusters • 3 essential application features

7. Core Competencies 1. Primary Care Management 2. Person Centred Care 3.Specific Problem Solving 4. Comprehensive approach 5.Community Orientation 6. Holistic Approach

8. “Three features are essential for a person-centred scientific discipline” • Contextual aspects • Attitudinal aspects • Scientific aspects

9. Primary care management includes the ability : • to manage primary contact with patients, dealing with unselected problems; • to cover the full range of health conditions; • to co-ordinate care with other professionals in primary care and with other specialists; • to master effective and appropriate care provision and health service utilisation; • to make available to the patient the appropriate services within the health care system; • to act as advocate for the patient.

10. Primary care management includes the ability : • to manage primary contact with patients, dealing with unselected problems; • to cover the full range of health conditions; • to co-ordinate care with other professionals in primary care and with other specialists; • to master effective and appropriate care provision and health service utilisation; • to make available to the patient the appropriate services within the health care system; • to act as advocate for the patient.

11. Aim 1: At the end of the training program the doctor will be able to manage the primary contact with patients. This will require: • knowledge of the epidemiology of problems presenting in primary care • mastering an approach which allows easy accessibility for patients with unselected problems • an organizational approach to the management of chronic conditions • knowledge of conditions encountered in primary care and their treatment

12. Assessment methods

13. Primary Care Management • MCQ • MEQ • Essay • OSCE • Direct observation • Discussion

14. Person Centred Care • Direct observation • Video • Patientfeedback • Indirect observation • Reflective portfolio

15. Specific Problem Solving • MCQ • MEQ • Oral examination • OSCE • Observation • Medical file audit

16. Comprehensive approach • MCQ • MEQ • Evaluation by tutor • Assessment in a group • Peer assessment • Observation of a simulated consultation

17. Community orientation • MCQ • MEQ • Report by tutor • Discussion with work-based teacher

18. Holistic approach • MCQ • MEQ • Oral exam • Tutor assessment over time • Observation of consultation • Case presentation

19. Role for EURACT • Collect valid data on assessment • Provide evidence for best methods

20. Role for EURACT • Collect valid data on assessment • Provide evidence for best methods • Promote political pressure to introduce appropriate methodology • Train GP teachers in assessment, particularly work-based and continuous methods • Harmonisation