Showing papers by "General Medical Council published in 2018"
TL;DR: Single‐best‐answer questions (SBAQs) have been widely used to test knowledge because they are easy to mark and demonstrate high reliability but have been criticised for being subject to cueing.
Abstract: CONTEXT: Single-best-answer questions (SBAQs) have been widely used to test knowledge because they are easy to mark and demonstrate high reliability. However, SBAQs have been criticised for being subject to cueing. OBJECTIVES: We used a novel assessment tool that facilitates efficient marking of open-ended very-short-answer questions (VSAQs). We compared VSAQs with SBAQs with regard to reliability, discrimination and student performance, and evaluated the acceptability of VSAQs. METHODS: Medical students were randomised to sit a 60-question assessment administered in either VSAQ and then SBAQ format (Group 1, n = 155) or the reverse (Group 2, n = 144). The VSAQs were delivered on a tablet; responses were computer-marked and subsequently reviewed by two examiners. The standard error of measurement (SEM) across the ability spectrum was estimated using item response theory. RESULTS: The review of machine-marked questions took an average of 1 minute, 36 seconds per question for all students. The VSAQs had high reliability (alpha: 0.91), a significantly lower SEM than the SBAQs (p < 0.001) and higher mean item-total point biserial correlations (p < 0.001). The VSAQ scores were significantly lower than the SBAQ scores (p < 0.001). The difference in scores between VSAQs and SBAQs was attenuated in Group 2. Although 80.4% of students found the VSAQs more difficult, 69.2% found them more authentic. CONCLUSIONS: The VSAQ format demonstrated high reliability and discrimination and items were perceived as more authentic. The SBAQ format was associated with significant cueing. The present results suggest the VSAQ format has a higher degree of validity.
50 citations
TL;DR: This paper describes the creation, structure and access arrangements for the first UK-wide attempt to create a research database, UKMED, to improve standards, facilitate workforce planning and support the regulation of medical education and training.
Abstract: Educating doctors is expensive and poor performance by future graduates can literally cost lives. Whilst the practice of medicine is highly evidence based, medical education is much less so. Research on medical school selection, undergraduate progression, Fitness to Practise (FtP) and postgraduate careers has been hampered across the globe by the challenges of uniting the data required. This paper describes the creation, structure and access arrangements for the first UK-wide attempt to do so. A collaborative approach has created a research database commencing with all entrants to UK medical schools in 2007 and 2008 (UKMED Phase 1). Here the content is outlined, governance arrangements considered, system access explained, and the potential implications of this new resource discussed. The data currently include achievements prior to medical school entry, admissions tests, graduation point information and also all subsequent data collected by the General Medical Council, including FtP, career progression, annual National Training Survey (NTS) responses, career choice and postgraduate exam performance data. UKMED has grown since the pilot phase with additional datasets; all subsequent years of students/trainees and stronger governance processes. The inclusion of future cohorts and additional information such as admissions scores or bespoke surveys or assessments is now being piloted. Thus, for instance, new scrutiny can be applied to selection techniques and the effectiveness of educational interventions. Data are available free of charge for approved studies from suitable research groups worldwide. It is anticipated that UKMED will continue on a rolling basis. This has the potential to radically change the volume and types of research that can be envisaged and, therefore, to improve standards, facilitate workforce planning and support the regulation of medical education and training. This paper aspires to encourage proposals to utilise this exciting resource.
47 citations
TL;DR: The EPM decile and SJT scores may be effective selection measures for the foundation programme, however, educational achievements does not add value to the other two measures when predicting programme completion, and its usefulness in this context is less clear.
Abstract: Objectives Currently relative performance at medical school (educational performance measure (EPM) decile), additional educational achievements and the score on a situational judgement test (SJT) are used to rank applicants to the UK Foundation Years postgraduate medical training programme. We sought to evaluate whether these three measures were predictive of subsequent successful completion of the programme, and thus were valid selection criteria. Methods Data were obtained from the UK Medical Education Database (UKMED) on 14 131 UK applicants to the foundation programme starting in 2013 and 2014. These data included training outcomes in the form of Annual Reviews of Competency Progression (ARCPs), which indicated whether the programme was successfully completed. The relationship between applicants’ performance on the three selection measures to the odds of successful programme completion were modelled. Results On univariable analyses, all three measures were associated with the odds of successful completion of the programme. Converting the SJT score to deciles to compare the effect sizes suggested that one decile increase in the EPM increased the odds of completing the programme by approximately 15%, whereas the equivalent value was 8% for the SJT scores. On multivariable analyses (with all three measures included in the model), these effects were only independently and statistically significant for EPM decile (OR 1.14, 95% CI 1.10 to 1.18, p Conclusions The EPM decile and SJT scores may be effective selection measures for the foundation programme. However, educational achievements does not add value to the other two measures when predicting programme completion. Thus, its usefulness in this context is less clear. Moreover, our findings suggest that the weighting for the EPM decile score, relative to SJT performance, should be increased.
31 citations
TL;DR: White ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits, which suggest students from non-professional backgrounds may be at increased risk of depression and therefore could benefit from targeted support.
Abstract: Misconduct during medical school predicts subsequent fitness to practise (FtP) events in doctors, but relatively little is known about which factors are associated with such issues during undergraduate education. This study exploits the newly created UK medical education database (UKMED), with the aim of identifying predictors of conduct or health-related issues that could potentially impair FtP. The findings would have implications for policies related to both the selection and support of medical students. Data were available for 14,379 students obtaining provisional registration with the General Medical Council who started medical school in 2007 and 2008. FtP declarations made by students were available, as were various educational and demographic predictor variables, including self-report ‘personality measures’ for students who participated in UK Clinical Aptitude Test (UKCAT) pilot studies. Univariable and multivariable logistic regression models were developed to evaluate the predictors of FtP declarations. Significant univariable predictors (p < 0.05) for conduct-related declarations included male gender, white ethnicity and a non-professional parental background. Male gender (OR 3.07) and higher ‘self-esteem’ (OR 1.45) were independently associated with an increased risk of a conduct issue. Female gender, a non-professional background, and lower self-reported ‘confidence’ were, among others, associated with increased odds of a health-related declaration. Only ‘confidence’ was a significant independent predictor of a health declaration (OR 0.69). Female gender, higher UKCAT score, a non-professional background and lower ‘confidence’ scores were significant predictors of reported depression, and the latter two variables were independent predictors of declared depression. White ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits. Students from non-professional backgrounds may be at increased risk of depression and therefore could benefit from targeted support. The small effect sizes observed for the ‘personality measures’ suggest they would offer little potential benefit for selection, over and above those measures already in use.
29 citations
TL;DR: The failure of recruitment patterns to mirror the ARCP data raises issues regarding consistency in selection and the deaneries’ subsequent annual reviews and regulators and selectors should continue to develop robust processes for selection and assessment of doctors in training.
Abstract: Objectives To compare the likelihood of success at selection into specialty training for doctors who were UK nationals but obtained their primary medical qualification (PMQ) from outside the UK (‘UK overseas graduates’) with other graduate groups based on their nationality and where they gained their PMQ. We also compared subsequent educational performance during postgraduate training between the graduate groups. Design Observational study linking UK medical specialty recruitment data with postgraduate educational performance (Annual Review of Competence Progression (ARCP) ratings). Setting Doctors recruited into national programmes of postgraduate specialist training in the UK from 2012 to 2016. Participants 34 755 UK-based trainee doctors recruited into national specialty training programmes with at least one subsequent ARCP outcome reported during the study period, including 1108 UK overseas graduates. Main outcome measures Odds of being deemed appointable at specialty selection and subsequent odds of obtaining a less versus more satisfactory category of ARCP outcome. Results UK overseas graduates were more likely to be deemed appointable compared with non-EU medical graduates who were not UK citizens (OR 1.29, 95% CI 1.16 to 1.42), although less so than UK (OR 0.25, 95% CI 0.23 to 0.27) or European graduates (OR 0.66, 95% CI 0.58 to 0.75). However, UK overseas graduates were subsequently more likely to receive a less satisfactory outcome at ARCP than other graduate groups. Adjusting for age, sex, experience and the economic disparity between country of nationality and place of qualification reduced intergroup differences. Conclusions The failure of recruitment patterns to mirror the ARCP data raises issues regarding consistency in selection and the deaneries’ subsequent annual reviews. Excessive weight is possibly given to interview performance at specialty recruitment. Regulators and selectors should continue to develop robust processes for selection and assessment of doctors in training. Further support could be considered for UK overseas graduates returning to practice in the UK.
11 citations
TL;DR: If you think conditions are unsafe, document the situation, but don’t walk away, Charlie Massey advises.
Abstract: If you think conditions are unsafe, document the situation, but don’t walk away, Charlie Massey advises
2 citations
TL;DR: While the matter of employment and increasing the number of home grown doctors is not for the GMC, which decides which organisations can award UK primary medical qualifications, the increase in student numbers or additional medical schools to lead to any decline in the high standards that UK medical education offers is not allowed.
Abstract: While the matter of employment and increasing the number of home grown doctors is not for the GMC, we decide which organisations can award UK primary medical qualifications, and we will not allow the increase in student numbers or additional medical schools to lead to any decline in the high standards that UK medical education offers.1
Our standards are there to ensure that patients …
TL;DR: The chair of the General Medical Council is keen to shed some light on his role and how it fits in a law abiding and democratic society in the Bawa-Garba case.
Abstract: The following is a letter of 12 February 2018 from the chair of the General Medical Council in reply to Nick Ross’s letter of 5 February 2018 (posted 8 February 2018).12
Dear Nick,
After your meeting and exchange of correspondence with Charlie Massey in recent weeks, I welcome the opportunity to respond to the points you raise in your letter to me of 5 February 2018.12
I have read in full the court judgments and GMC decisions taken around the Bawa-Garba case, and I am keen to shed some light on our role and how it fits in a law abiding and democratic society.
I understand that you find the decision taken in this case hard to accept. I also recognise the anxiety felt in parts of my profession. We have publicly acknowledged that concerns about manslaughter by gross negligence convictions, and this subsequent judgment, could make doctors less candid about errors and that this case has set us back in our goal to support doctors as the best way of protecting patients. We are working hard to overcome this and the considerable misunderstanding and frustration, which are not entirely grounded in fact.
At the heart of this tragic case, a person was convicted in …