MRCGP single route videoLearning together

Dr Alison Evans

Dr Paul Robinson

Dr Liz Moulton

Aims:

For participants to:• explore collaborative ways of working on

consultation skills• develop their consultation and feedback

skills• be familiar with MRCGP performance

criteria, and requirements for summative assessment

MRCGP video

• 7 consultations – at least one with a child under 10 years of age, and at least one with a significant social or psychological dimension

• only the first 15 minutes of a consultation will be assessed

COGPED video assessment

• 2-hour tape with at least 8 consultations, preferably more

• must have date and clock time on the tape and log, no consultation longer than 20 minutes

• standard VHS tape at normal speed with good quality sound and vision

MRCGP marking

• 14 performance criteria (PC), 10 pass and 4 merit

• must display each PC at least 4 times in the 7 consultations

• each consultation marked by a different marker

COGPED marking

• Two 1st-level markers view minimum 6 and maximum 10 consultations

• assess listening, action, understanding (from logbook), and any major or minor errors

• assessors rate the level of challenge

• each consultation scored P+, P, R, or R+, then final judgement made

MRCGP results

• May 2004 – 17% of single route candidates failed MRCGP (22% of non-SR candidates failed)

• 65% of those who failed did not demonstrate PC 12 –

“The patient is given the opportunity to be involved in significant management decisions.”

Other failing criteria:

• “The doctor specifies the conditions and interval for follow up or review.” (35%)

• “The doctor obtains sufficient information to include or exclude likely relevant significant conditions.” (28%)

• “The doctor explores the patient’s health understanding.” (24%)

• “The doctor uses appropriate psychological and social information to place the complaint(s) in context.” (21%)

Use of video-tape:

• supportive setting

• reviewing the teacher’s own material is the most influential part of teacher training

• try to choose consultations with some ‘meat’ in them

Group process and tasks:

• establish ground rules

• the person who did the consultation provides background to the consultation and says what they would like help with

• try out a variety of ways of using the tape in teaching

Process and tasks -

• positive feedback

• constructive suggestions

• active learning

• rehearsal of alternatives

Role of facilitator:

• helping group to establish and keep to the ground rules

• facilitating agenda setting

• timekeeping

Role of facilitator

• keeping group to task

• modelling teaching, including summarising learning points, checking with learners