Quality management of GP training

Our role in quality managing GP training involves working in close partnership with the postgraduate deaneries and the GMC. For each training year we submit an Annual Specialty Report to the GMC, providing a national overview on GP training with information on trends, examinations data, and good practice.

Quality managing the GP curriculum and assessments

All postgraduate medical education curricula and assessment systems, including the MRCGP’s Workplace Based Assessment (WPBA), Applied Knowledge Test (AKT), and Clinical Skills Assessment (CSA), must be mapped to the specialty’s curriculum and approved by the GMC before they can be implemented. And reviwied approved by the GMC in 2010.

The GP curriculum and MRCGP were approved by PMETB (the previous regulator) in 2007. The three components of the MRCGP test different competences using validated assessment methods. The utility, validity, reliability, feasibility, cost effectiveness, opportunities for feedback and impact on learning of each assessment method, and of the assessment system as a whole, complies with standards defined by the GMC, as well as best assessment and educational practice in terms of quality assurance and standard-setting.

Applied Knowledge Test (AKT)

The AKT is quality assured through comprehensive item-writing, question-banking, question selection, standard setting and linear equating processes.

Clinical Skills Assessment (CSA)

The validity of the CSA resides in its realistic simulation of real-life consultations. It uses trained and calibrated role-players, and cases that are written and assessed by working GPs.

The format of the assessment also allows for systematic sampling from the curriculum, using a selection blueprint. Candidates are assessed on 13 consultations of ten minutes each across three circuits run simultaneously; a calibration exercise is carried out on each case at the start of each day, involving assessors and role-players; assessors are trained, calibrated and monitored; cases are selected according to a blueprint to ensure comparability from one assessment to another; and the performance of cases is reviewed on an ongoing basis.

Workplace Based Assessment (WPBA)

Deaneries are responsible for the management of the quality of WPBA locally. RCGP has overall responsibility for ensuring quality through the design and development of the WPBA tools, and is responsible for delivering suitable mechanisms for recording WPBA in the Trainee ePortfolio.

External scrutiny

The Gold Guide requires that royal colleges have a role in quality managing deanery Annual Reviews of Competence Progression (ARCPs), helping ensure that deaneries make consistent decisions about trainees’ progress. All unsatisfactory ARCP outcomes come under external scrutiny, as well as 10 per cent of satisfactory outcomes.

External Advisors

Detailed external scrutiny is provided by the RCGP’s team of External Advisors, recruited from around the country. They visit a sample of ARCP Panels in the deaneries during the summer period to observe the panel process. External Advisors also remotely quality manage a sample of Trainee ePortfolios twice per year.

External Advisors provide feedback to the GP directors on their deanery’s educational supervisors reviews, clinical supervisors reports, and ARCP outcomes. This feedback provides suggestions for the deanery. External Advisors are also involved in ARCP appeal panels and special concerns visits, at a deanery’s request.

Promoting high standards in GP training

Reporting

For each training year we submit an Annual Specialty Report to the GMC, providing a national overview on GP training including trends, innovations, examinations data, and good practice. This report forms part of the evidence set used by the GMC to regulate and promote postgraduate medical training in the UK and has been highly commended by the GMC in the past.

Best practice guidance

Every year RCGP organises a meeting to discuss best practice in WPBA and ARCPs for RCGP External Advisors and Deanery Assessment Leads. The guidance circulated after these meetings informs the work of External Advisors and deaneries.

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