United Kingdom
JCHMT assessment tools are now available
Mar 24, 2005 - 5:55:00 PM

Assessment of the performance of doctors has become an important issue as a result of high profile cases and the redesign of medical training. Following the launch of the new competency based curricula, the Joint Committee on Higher Medical Training of the three Royal Colleges of Physicians of the UK developed three methods of measuring the clinical skills and personal behaviours of SpRs across 30 specialties and sub-specialties. These methods were then piloted to assess their reliability and feasibility.

Currently, information presented at the Record of In Training Assessment (RITA) for SpRs on higher medical training programmes is based on subjective judgements. Outcomes of valid, reliable and feasible methods of performance assessment are needed to inform the RITA process. The three methods tested in the pilot study are:

Assessment of the clinical encounter- mini-CEX (clinical evaluation exercise) - this method was adapted from the existing mini-CEX in use for the assessment of trainees in the USA.

Assessment of procedural skills- Directly Observed Procedural Skills (DOPS) - this method was designed and developed by the Colleges. For the purpose of the pilot DOPS forms were developed for four specialities only (cardiac catheterisation, endoscopy, neurophysiology studies and renal biopsy)

Assessment of behaviours by colleagues- 360 degrees (3600) assessment - the Colleges developed their own 3600 assessment tool, using ‘raters’ from four groups (allied health professionals, doctors, nurses and secretarial/clerical staff)

Provisional analysis of the results suggest that the methods are reliable and feasible. Final analysis of the results and study publication are awaited, following which a further press release will be issued. The tools will now be rolled out across the UK during 2005. The JCHMT has produced a DVD/CD-ROM explaining the tools – this will be distributed to College Tutors, Regional Advisers and other physicians key to the education and training of SpRs.

Dr George Cowan, Medical Director of the Joint Committee for Higher Medical Training, said:

“The pilot study involved structured observation by trainers, and by all the hospital staff with whom the SpRs interact, in real-time clinical practice in out-patients, during ward rounds, and during special investigations such as endoscopy or cardiac catheterisation. Scoring and reporting sytems have been validated which will provide evidence for the annual Record of In-Training Assessment (RITA). RITA will therefore be much more objective and comprehensive than at present, providing assurance that all physicians in training have covered the complete curriculum and acquired all the necessary skills and attitudes for consultant practice. Separate work is going ahead on new methods of assessing specialist knowledge using on-line systems"

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