NHS Scotland's community GP fellowship - a qualitative study of the first year.

NHS Scotland faces the challenges of an ageing population and a GP recruitment problem. Research has shown that hospital admissions can be reduced if community services can offer enhanced support, in keeping with the Scottish Government's 2020 Vision for healthcare. This study presents the findings of an evaluation of the first year of a three-year community GP fellowship which included working in primary care and secondary care and an educational programme.

Piloting a quality improvement (QI) project in final year general practice trainees: setting up and evaluating the processes.

There is limited evidence on the effectiveness of educational initiatives designed to support and encourage training doctors to undertake quality improvement projects (QIP) at their workplace. The purpose of this study was to examine the feasibility of the RCGP proposal to implement a QIP in the final year of training. An educational intervention was designed and delivered to a group of GP trainees six months before the end of their training.

Are there practical opportunities for developing leadership skills during GP training and beyond? A survey of GP trainees and trainers in South East Scotland.

Background: There is currently a lack of formal training in leadership skills, particularly during GP training. This study aimed to explore the current training and practical opportunities which exist, specifically exploring the views of GP trainees and trainers.

Methods: An electronic questionnaire was sent to 266 GP trainees and trainers in south-east Scotland.

Do role-players affect the outcome of a high-stakes postgraduate OSCE, in terms of candidate sex or ethnicity? Results from an analysis of the 52,702 anonymised case scores from one year of the MRCGP clinical skills assessment.

The MRCGP clinical skills assessment (CSA), a high-stakes OSCE examination whereby GPs exit their training, uses trained role-players to depict patients (though not to mark candidates). Just as subgroups of examiners can potentially affect the results of subgroups of candidates through biases expressed in discriminatory marking, so possibly could subgroups of role-players alter the difficulty for different candidate groups. This study looks at the contribution of role-players to such possible systematic unfairness in the assessment.

Cross-comparison of MRCGP & MRCP(UK) in a database linkage study of 2,284 candidates taking both examinations: assessment of validity and differential performance by ethnicity.

Background: MRCGP and MRCP(UK) are the main entry qualifications for UK doctors entering general [family] practice or hospital [internal] medicine. The performance of MRCP(UK) candidates who subsequently take MRCGP allows validation of each assessment. In the UK, underperformance of ethnic minority doctors taking MRCGP has had a high political profile, with a Judicial Review in the High Court in April 2014 for alleged racial discrimination.

Signposting GP trainees to relevant learning opportunities in hospital posts:the Super-condensed Curriculum Guide.

UK three-year GP specialty training programmes consist of 18 months in hospital posts and 18 months in general practice. Within the hospital setting, clinical supervisors of GP trainees may have difficulty determining which learning opportunities available within the post are most relevant to training for a future career in general practice. Feedback from GP trainees has indicated that there is a lack of consistency in hospital posts regarding relevance of training for general practice.

MRCGP CSA: are the examiners biased, favouring their own by sex, ethnicity, and degree source?

Background: Concern exists regarding differential performance of candidates in postgraduate clinical assessments by ethnicity, sex, and country of primary qualification. Could examiner bias be responsible?

Aim: To explore whether candidate demographics affect examiners' judgements, by investigating candidates' case performances by candidates' and examiners' demographics.

Design And Setting: Data on 4000 candidates (52,000 cases) sitting the MRCGP clinical skills assessment in 2011-2012.

A new competency model for general practice: implications for selection, training, and careers.

Background: Recent structural and policy changes in the UK health service have significantly changed the job responsibilities for the GP role.

Aim: To replicate a previous job analysis study to examine the relevance of current competency domains and selection criteria for doctors entering training.

Design And Method: A multisource, multimethod approach comprising three phases: (1) stakeholder consultation (n = 205) using interviews, focus groups and behavioural observation of practising GPs; (2) a validation questionnaire based on results from phase 1 (n = 1082); followed by (3) an expert panel (n = 6) to review and confirm the final competency domains.

Experiences of simulated patients and candidates in the Membership of the Royal College of General Practitioners Simulated Surgery examination.

WHAT IS ALREADY KNOWN IN THIS AREA • Simulated patients (SPs) experience stress related to their performance as SPs. • SPs' consistency is maximised by regular training for them and the examiners. • The likelihood of stress may be related to role type and SP acting style.

Simulated Surgery-an exam for our time? Summary of the current status and development of the MRCGP Simulated Surgery module.

WHAT IS ALREADY KNOWN IN THIS AREA • The Simulated Surgery module of the MRCGP examination has been shown to be a valid and reliable assessment of clinical consulting skills. WHAT THIS WORK ADDS • This paper describes the further development of the methodology of the Simulated Surgery; showing the type of data analysis currently used to assure its quality and reliability. The measures taken to tighten up case quality are discussed.

Ensuring reliability in UK written tests of general practice: the MRCGP examination 1998-2003.

Reliability in written examinations is taken very seriously by examination boards and candidates alike. Within general education many factors influence reliability including variations between markers, within markers, within candidates and within teachers. Mechanisms designed to overcome, or at least minimize, the impact of such variables are detailed.