Trainer Support FAQs
Will trainers
be trained in the use of the wpba tools?
What is the nMRCGP?
Why is the nMRCGP
needed?
Are there any other
advantages of the nMRCGP?
Why is a licensing
process necessary?
What competences are
tested in the nMRCGP assessment package?
What is the Workplace Based
Assessment?
Who is responsible for the
different parts of the nMRCGP assessment package?
When is it
compulsory to sit the nMRCGP?
What
opportunities do candidates have to complete elements of
assessment from the current MRCGP which can contribute to the award
of a CCT via Summative Assessment?
I hear there
has been an extension of the opportunity to take the old MRCGP: is
that correct?
What happens
if a candidate fails the nMRCGP?
Will trainers
be trained in the use of the wpba tools?
The RCGP has agreed with COGPED that deaneries will take
responsibility for ensuring GP trainers are fully familiar with the
use of the tools. This fits with the role of deaneries in
appointing trainers and quality assuring the local delivery of
workplace based assessment. It also means that training will
normally be provided locally to trainers.
The RCGP has provided training and resources for senior GP
educators nominated by their deaneries to cascade the training to
GP trainers. The RCGP can put trainers in touch with the
appropriate person in their deanery if required.
What is the nMRCGP?
- The nMRCGP is not an examination; it is an assessment system
designed to test knowledge, skills, behaviours and attitudes
defined by the GP curriculum and "Good Medical Practice" over the
whole of the period of specialty training in general practice.
- It comprises an Applied Knowledge Test (AKT), Clinical Skills
Assessment (CSA) together with Workplace Based Assessments (WPBA)
conducted throughout the whole period of training.
- The AKT and CSA are externally applied and validated tests of
competence in knowledge and clinical skills respectively. The
Workplace Based Assessments test performance in the workplace by
standardised and validated assessment tools, some assessed by the
trainer (Case-based Discussion, Consultation Observation Tool, Mini
Clinical Evaluation Exercise, Direct Observation of Procedural
Skills) and others by colleagues (Multi-source feedback) and
patients (Patient satisfaction questionnaire).
- Assessments in the nMRCGP package are part of a development
process – word pictures in the assessment guidance of the CSA and
the enhanced trainer report define what types of knowledge, skills,
behaviours and attitudes need further development, define
competence or show progression to excellence.
- There is an emphasis on the thorough assessment of performance
in the workplace.
- The evidence collected is suitable for NHS appraisal.
- The nMRCGP will be the licensing assessment at the end of
training in General Practice. Successful completion of all
components of the nMRCGP, together with satisfactory completion of
the training programme, results in candidates being awarded a
Certificate of Completion of Training (CCT) and College
Membership.
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Why is the nMRCGP
needed?
The nMRCGP is an assessment system devised to
assess the GP curriculum and “Good Medical Practice” and also meet
the requirements of PMETB’s principles for an assessment system for
postgraduate training.
The nMRCGP assessment process will further the
integration of assessment and teaching. It is a movement towards a
“whole task” integration of assessment of performance - measuring
what the registrar “does do” in practice compared to what they “can
do” in an isolated single examination. It will test knowledge,
skills, behaviours and attitudes defined by the new GP curriculum.
It is developmental – the word pictures of the competency
statements of the nMRCGP will help define excellence as well as
competence - enabling the registrar to see a route to further their
development. The evidence collected within the portfolio will help
satisfy the requirements of NHS appraisal.
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Are there any other advantages of the
nMRCGP?
- It will replace the dual system (NOSA and MRCGP) and should
thus free up time for teaching and learning rather than
assessment.
- It includes a formal test of clinical skills.
- It links in concept and content with previous
learning/assessments in undergraduate training or foundation years,
and does not assess minor skills which should be learned and tested
at an earlier stage of training.
- The ePortfolio which supports nMRCGP will help trainer and
trainee to plan and record progression through all three years of
training and will make the developmental journey of the registrar
more visible.
- Evidence from training in hospital posts will be systematically
recorded and will form part of the overall assessment of the
trainee.
- Trainers will be able to make judgements based on structured,
systematically recorded evidence which can be built up over three
years; the final assessment will be calibrated within and across
deaneries. This means there is more support for trainers in making
an overall judgment about their registrar’s readiness for
practice.
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Why is a licensing
process necessary?
In order to protect patients from doctors who may not have
reached the minimum level of competence and be safe for independent
practice at the end of the standard period of GP specialty
training. Doctors who fail the licensing examination will normally,
at the discretion of the Deaneries, be given a further period of
training in order to achieve the required competencies.
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What competences are tested
in the nMRCGP assessment package?
1. Communication and consultation skills. This
competence is about communication with patients, and the use of
recognised consultation techniques.
2. Practising holistically - the ability of the
doctor to operate in physical, psychological, socioeconomic and
cultural dimensions, taking into account feelings as well as
thoughts.
3. Data gathering and interpretation - the
gathering and use of data for clinical judgement, the choice of
physical examination and investigations, and their
interpretation.
4. Making a diagnosis / making decisions. This
competence is about a conscious, structured approach to decision
making.
5. Clinical management - the recognition and
management of common medical conditions in primary care.
6. Managing medical complexity and promoting
health - aspects of care beyond managing straightforward
problems, including the management of co-morbidity, uncertainty,
risk and the approach to health rather than just illness.
7. Primary care administration and IMT - the
appropriate use of primary care administration systems, effective
recordkeeping and information technology for the benefit of patient
care.
8. Working with colleagues and in teams -
working effectively with other professionals to ensure patient
care, including the sharing of information with colleagues.
9. Community orientation - the management of
the health and social care of the practice population and local
community.
10. Maintaining performance, learning and
teaching - maintaining the performance and effective
continuing professional development of oneself and others.
11. Maintaining an ethical approach to practice
- practising ethically with integrity and a respect for
diversity.
12. Fitness to practise - the doctor's
awareness of when his/her own performance, conduct or health, or
that of others, might put patients at risk and the action taken to
protect patients.
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What is the Workplace Based
Assessment?
The workplace-based assessment consists of a
number of tools designed to collect evidence of competencies. These
will include direct observations of clinical practice
- the Consultation Observation Tool (COT) in general
practice,
or the Clinical Evaluation
Exercise (mini-CEX) in hospital practice,
- Case-based Discussions (CbD’s)
in general practice and in hospital practice
- Multi-source feedback (360
degree assessment) from colleagues
- Patient Satisfaction
Questionnaire (PSQ)
- Audit participation
- Significant event analysis
participation
- Direct Observation of Procedural Skills
(DOPS)
Further information on the assessment tools can be found on the
WPBA webpages.
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Who is responsible for the different
parts of the nMRCGP assessment package?
The Royal College of General Practitioners is responsible for
the Applied Knowledge Test and the Clinical Skills Assessment. The
Deaneries are responsible for the delivery of the Workplace-based
Assessments.
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When is it compulsory to sit the nMRCGP?
All those starting training on or after 1
August 2007 will be required to complete the nMRCGP in order to
acquire a CCT. Those who have commenced training prior to 1st
August 2007, but who have not applied for any summative assessment
components by 31st July 2007 will also be eligible for nMRCGP.
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What
opportunities do candidates have to complete elements of
assessment from the current MRCGP which can contribute to the award
of a CCT via Summative Assessment?
The elements of the current MRCGP used for summative assessment,
and summative assessment itself, will not be available after 31
July 2008. However, if a candidate has applied to sit the
old MRCGP before the 29 August 2007 and has completed some
summative assessment components before the 1st August 2008, they
will be able to achieve the Certificate of Completion of Training
by passing the components of the nMRCGP to complete their
assessment. The transitional arrangements between summative
assessment and nMRCGP are described in detail in Information
Sheet 3.
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I hear there has
been an extension of the opportunity to take the old MRCGP: is that
correct?
Yes. The arrangements for transition between the current MRCGP
examination and the nMRCGP assessment process have been amended to
accommodate those who will not have time to complete the Workplace
Based Assessment (WPBA) of nMRCGP, for example those starting their
final year of training in February 2007.
WPBA will be available from August 2007. The College considers
that it is impractical and inappropriate to attempt WPBA in just
six to eleven months. GPStRs completing training before the
end of July 2008, ie those with less than 12 months of training to
complete from August 2007, have been advised by their deaneries,
the College and NOSA, to apply for summative assessment (for a CCT)
and, if they wish, the current MRCGP examination. Many
registrars have already applied for either the summer or winter
2007 examination sessions, but some missed the deadline. The
closing date for applications to the winter 2007 MRCGP examination
session (Wednesday 29 August 2007) remains unchanged, but this will
be open to first time applicants, as well as those wishing to
complete the examination or re-sit modules previously failed.
In order to ensure that all applicants have the option of three
attempts at each module, the cut-off point for the availability of
MRCGP components has been extended by six months to include a
Written Paper session in October 2008 and Oral examinations in
November/December 2008. Candidates who still require passes
in the Multiple Choice Paper and Consulting Skills modules of the
current MRCGP at that time will be required instead to attempt the
nMRCGP Applied Knowledge Test (AKT) and Clinical Skills Assessment
(CSA) respectively.
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What happens if a candidate fails the
nMRCGP?
The applied knowledge test, the clinical skills assessment and
the workplace based assessments ought to be passed within the
period of GP specialty training. If it is not passed then the
Deanery has the discretion to fund a further period of training to
allow further time to complete this assessment to a satisfactory
standard. It is anticipated that an extended period of training
will normally be provided. Other outcomes, if failure persists,
could be career counselling and exiting from training in General
Practice.
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