practical gp skills
The structured trainers report part of summative assessment focuses on the more practical aspects of GP work. Colonel Jonathan Leach looks at ways to approach it
Perhaps the most important part of summative assessment is the fourth element, the structured trainers report (STR). It addresses areas that are not covered in other parts of the process, particularly the more practical parts of being a GP.
The same form is used throughout the UK. It comprises three main areas: clinical skills; patient care, such as patient management and making a diagnosis; and personal skills including organisational skills, professional values, and personal and professional growth.
Failure is normally avoidable with the structured trainers report, so it is important to complete it correctly and on time.
The report can be downloaded in full from the National Office for Summative Assessment website: www.nosa.org.uk. It covers a range of competencies and lists the fail criteria for each.
For example, the doctor must 'demonstrates effective communication skills when dealing with patients'. He will fail this section if he does not:
· Create rapport with the patient (including listening, explaining and noticing patient cues)
· Clarify the patient's reason for consulting
· Convey information to the patients on his/her assessment and management plan that enables the patient to understand what is being said (including the use of language tailored to the particular patients)
You can maximise your chances of success by taking on board the following points:
· The STR is designed to be filled during training and not left until the end. It is recommended that the specific clinical skills section such as showing competence in the use of an auroscope or peak flow meter be completed early, the patient care section next and finally the personal skills element. The final assessment should be completed six weeks before the expected date of finishing GP training.
· Assessments can be performed in several ways. They should include observation (direct or video) by the trainer or other health professional; case analysis (problem or random case analysis); tutorials; or simulated patients (an OSCE, simulated surgery or a manikin).
· While the trainer is expected to have a major input into the report, and must provide the final signature, other members of the practice, including nurses and allied professions or sometimes patients, can sign elements of it. Details of who may sign are given in annex B to the report.
· To pass the STR, all elements must be signed off. The report contains guidance on the fail criteria. I strongly recommend that any concerns regarding an individual doctor are discussed first with the doctor concerned and with other colleagues such as partners and course organisers. Concerns must be documented to include specific events as appropriate.
· Doctors who have more than one
trainer or training practice should
ensure the report is partially completed
by the first trainer. It is helpful if as
much information as possible is given by this trainer, as the second trainer is required to complete the form and sign the final assessment.
· When the form is completed, I recommend the registrar and trainer keep a copy each. The registrar can use it as evidence in appraisal, but it is useful to have a copy anyway.
· Further information is available from the National Office For Summative Assessment website: www.nosa.org.uk
Jonathan Leach is director of general practice education for the Armed Forces deanery