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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

nMRCGP Assessments on the e portfolio

A summary for hospital clinical supervisors

Maggie Eisner

June 2009

components of nmrcgp
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
the e portfolio
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
assessment of progress
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
number of assessments required before es mtg in month 4
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
case based discussion what and how
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
case based discussion the competencies
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
case based discussion rating
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
case based discussion making it useful
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
further information
Further information
  • www.bradfordvts.co.uk: nMRCGP for Consultants – Elderly medicine
  • www.rcgp.org.uk: GP curriculum
  • 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)