I recently retired after 30 years of being a trainer and I find the fall in pass rate in the clinical skills assessment exam sad, but unsurprising.
We have become so preoccupied with assessment and recording data during training that there is little time left for teaching and learning. Tutorials are taken up with mechanically marked video assessments and case discussions. Trainees become proficient at ticking boxes but not at the rounded process of clinical assessment and decision-making.
And the recording of everything the trainee does, says, thinks or experiences on the RCGP’s clunking and time-consuming website teaches trainees that it doesn’t really matter what you do, as long as you record it diligently.
We have extrapolated inappropriately from research tools which are useful for assessing doctor behaviour and just assumed they can be used for everyday clinical practice.
If general practice teaches anything, it is that time is a precious, limited commodity and should not be squandered on pointless (or point-full!) activities that achieve little and prevent doctors from focusing on the reason for their role – their patients. Medical schools still attract the most able, motivated and diligent students. If they fail to perform adequately at the end of their training, it is their training that is to blame.
The results are talking to you, RCGP examiners. Listen to them!
From Dr Arnold Zermansky
Trainees are not being taught the the process of clinical assesment