Crammer's Corner
GP at the Fern Hill Practice, Faringdon, and RCGP Curriculum Development Fellow
E-mail: ben.riley{at}nhs.net
Each month, Crammer's Corner will feature useful info and practical advice to help you learn the core knowledge and skills described in the RCGP training curriculum and to help you prepare for the new MRCGP assessments.
This month, the first Crammer's Corner covers the basics of the three new MRCGP assessments, including information on what you should expect, what each assessment tests, and some advice to help you pass it.
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The Crammer's Guide to the Applied Knowledge Test (AKT) |
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AKT – What should I expect?
This assessment, made of 200 multiple-choice questions, tests how you apply knowledge in a GP context. It is held at Pearson VUE computer centres across the country and the assessment is completed on computer.
There are three basic question formats:
- Extended matching questions.
- Single best answer.
- Algorithm/table format.
For an example of each of these question formats, look here on the RCGP website: http://www.rcgp.org.uk/Docs/AKT sample questions.doc
AKT – What's being tested?
The AKT tests your decision-making, particularly in relation to undifferentiated problems and the ability to evaluate evidence. Patient safety is also an important consideration. The questions are distributed as follows:
- Clinical medicine (80%).
- Admin and informatics (10%).
- Research, appraisal, EBM, statistics (10%).
AKT – How do I pass it?
To pass the AKT, you need to develop a broad working knowledge of general practice (i.e. the knowledge base described in the curriculum). Remember to answer based on published evidence not local NHS arrangements, which may vary. Keep up-to-date with current practice (e.g. NICE guidelines and hot topics) and familiarize yourself with the question formats. Example AKT-type questions will be published in each monthly edition of InnovAiT and these are available online at the InnovAiT website: www.rcgp-innovait.oxfordjournals.org
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The Crammer's Guide to the Clinical Skills Assessment (CSA) |
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CSA – What should I expect?
The CSA assesses your behaviour in a mock surgery. You must undertake 13 consultations of ten minutes (although only 12 count towards your final mark, one is used to evaluate cases for future exams). You will remain in your consulting room and the patients, played by trained actors, will come to see you. The CSA is currently only available at one trendily refurbished centre, in Croydon, and takes place three times a year, during February, May and October.
Candidates are required to bring their normal doctor's bag and will be notified in advance of any specific equipment required. Remember to take your favourite stethoscope, otoscope and ophthalmoscope (with fresh batteries), so you have familiar tools to use on the day!
CSA – What's being tested?
The CSA tests your clinical, communication and practical skills in the following areas:
- Primary care management.
- Problem-solving skills.
- Comprehensive approach.
- Person-centred approach.
- Attitudinal aspects.
- Specific clinical skills.
- Patient safety.
CSA – How do I pass it?
It is recommended that you should get at least 6 months experience of general practice before attempting the CSA. Each candidate's performance is graded as clear pass, marginal pass, marginal fail or clear fail. The examiners are trained and experienced MRCGP assessors and all candidates will receive feedback on their performance. To pass you must demonstrate you have the knowledge, skills and attitudes to work independently as a GP, as described in the curriculum.
One of the best ways to prepare for the CSA is to video lots of your consultations and analyse them with your trainer. Joint surgeries and role-play (aarrgh!) are also useful ways to develop your consultation skills.
The RCGP has published a DVD and workbook for candidates preparing for the CSA, which is available from the RCGP's online bookshop: http://www.rcgp.org.uk/acatalog/RCGP_Curriculum_and_MRCGP.html.
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The Crammer's Guide to Workplace-Based Assessment (WPBA) |
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WPBA – What should I expect?
The WPBA brings together teaching, learning and assessment and is designed around the completion of an enhanced trainer's report. This requires the trainee to maintain a Training Record (TR) to house a portfolio of evidence that enables the trainer to judge the trainee's progress and give feedback in each of the twelve MRCGP competency areas.
WPBA – What's being tested?
The WPBA focuses on assessing the everyday behaviours a GP performs at work. These behaviours are described in the 12 nMRCGP competency areas. These competency areas are directly based on the six domains of competence and the three essential application features described in the core curriculum statement ‘Being a General Practitioner’.1
WPBA – How do I pass it?
To pass the WPBA part of the nMRCGP, you must collect evidence that you have developed the expertise required to be a competent, independent GP.
The RCGP's e-Portfolio is intended to store all the evidence you need to collect in order to complete the WPBA. This evidence is harvested using a range of assessment tools available on the e-Portfolio website, such as the Consultation Observation Tool (COT), Multi-Source Feedback (MSF) and the Patient Satisfaction Questionnaire (PSQ). The e-portfolio stores your TR, which must include:
- Evidence of your competency Progress in the 12 MRCGP competency areas must be recorded at regular intervals, or you won’t be passed.
- A record of your learning activities Such as tutorials, group learning, seminars, to demonstrate your learning.
- Your technical skills log Including the Direct Observation of Procedural Skills assessment (DOPS).
The WPBA continues throughout the whole three-year GP training period, during which time you undertake 6-monthly reviews with your clinical supervisor (if in secondary care) and your GP trainer. At the end of the three-year training period, a final review is carried out. Following this, your trainer makes a recommendation to your local deanery about whether you have demonstrated you are competent to work independently. To complete your training successfully, you must have recorded enough evidence to demonstrate you are competent in all twelve of the new MRCGP competency areas (see ‘The new MRCGP • what's it all about?’ article on page 49).
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Notes |
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1 RCGP Curriculum Statement 1: Being a General Practitioner, RCGP (available at: www.rcgp-curriculum.org.uk)
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