The Case-based Discussion (CbD) is a structured interview designed to assess your professional judgement in clinical cases. CbD is one of the tools used to collect evidence for your Trainee ePortfolio, as part of the Workplace Based Assessment component of the MRCGP exam.
How Case-based Discussion (CbD) works
The CbD tool has been designed to be used in both hospital and GP settings. For information about who can complete CbD, please see the guidance on who can act as an assessor for workplace based assessments.
Selecting cases for CbD
As a GP trainee, you’re responsible for selecting cases, requesting a CbD and ensuring the paperwork is completed properly. You and your trainer should ensure that your ePortfolio reflects a balance of cases, including:
- children
- mental health
- cancer and palliative care
- older adults
Cases should also reflect different contexts: surgery, home visits and out-of-hours contacts. You can’t include cases that have already been used as a debrief.
Specialty training years one and two (ST1 and ST2)
In ST1 and ST2, you’ll select two cases. You present the clinical entries and relevant records to your clinical supervisor or educational supervisor one week before the discussion. Your clinical or educational supervisor selects one of these cases for discussion.
Specialty training year three (ST3)
In ST3, you’ll present four cases to your trainer or educational supervisor one week before the discussion. They will select one or two for discussion.
What’s covered in the discussion
The discussion is framed around the actual case rather than hypothetical events. Questions should be designed to elicit evidence of competence: the discussion should not shift into a test of knowledge.
Your trainer or educational supervisors will aim to cover as many relevant competences as possible in the time available. It’s unrealistic to expect all competences to be covered in a single CbD, but if there are too few you won’t have sufficient evidence of progress. It’s helpful to establish at the start of the discussion which competence areas your trainer or supervisor is expecting to look at.
The trainer or educational supervisor records the evidence harvested for the CbD in the Trainee ePortfolio, against the appropriate competences.
It is recommended that each discussion should take about 30 minutes, including the discussion itself, completing the rating form and providing feedback.
When the CbDs happen
In full-time training you’ll need to carry out a minimum of six CbDs in each of ST1 and ST2 (three before each six month review). In ST3, you carry our 12 CbDs (six before the six month review, and six before the final review).
These minimum requirements apply whether you’re in a placement in primary or secondary care. You can do more CbDs if your trainer agrees - for example, if you’re short of evidence in a particular competence area.
CbD form and guidance
CbD question generators