BMJ 2001;322:1600 ( 30 June )

Letters

Assessing clinical competence and revalidation of clinicians

    Simulated surgeries would have advantages
    Video assessments might be effective screening method
    Authors' reply
    Results from pilot study using portfolio and 360° questionnaire

Simulated surgeries would have advantages

The first 150 words of the full text of this article appear below.

EDITOR---McKinley et al present cogent arguments for directly assessing the consultation competence of general practitioners undergoing revalidation.1 They identify the required attributes of an assessment as reliability, validity, acceptability, feasibility, and educational impact. They do not mention, however, that the methodology must also be capable of setting a consistent standard for pass/fail decisions for every candidate.

The model that they offer depends on the judgment of two observers watching 10 consecutive consultations, a task that they might undertake 12 times in a year. If the prevalence of insufficient competence was 2% they might encounter it once every four years. How could they apply a minimum standard reliably, along with their 1000 assessor colleagues? Just 10 randomly presenting cases will be too few to guarantee an adequate coverage of consultation skills, and in the absence of standardisation it will be hard to achieve a reliability score above 0.5. Furthermore, the patients will behave differently . . . [Full text of this article]
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This article has been cited by other articles:

  • Norman, G. R, Shannon, S. I, Marrin, M. L (2004). The need for needs assessment in continuing medical education. BMJ 328: 999-1001 [Full text]  
  • Lehman, R. (2001). Revalidation and assessment: giving marks might help. BMJ 323: 810-810 [Full text]  

Rapid Responses:

Read all Rapid Responses

Professional Revalidation and Assessment
Richard Lehman
bmj.com, 15 Jul 2001 [Full text]
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