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nMRCGP Assessments: Summary for Hospital Clinical Supervisors

This summary provides an overview of the nMRCGP assessments relevant for hospital clinical supervisors, detailing key components such as the Applied Knowledge Test, Clinical Skills Assessment, and various workplace-based assessments. It emphasizes the importance of the e-portfolio in tracking trainee progress, outlining the role of clinical supervisors and educational supervisors in the assessment process. Additionally, it touches on the mandatory assessments required during training and the competencies evaluated across different assessment types.

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nMRCGP Assessments: Summary for Hospital Clinical Supervisors

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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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