Bodgener Susan, Denney Meiling, Howard John
a Royal College of General Practitioners , London , UK.
b Health Education England, East of England Office , Cambridge , UK.
Educ Prim Care. 2017 Jan;28(1):45-49. doi: 10.1080/14739879.2016.1229579. Epub 2016 Sep 15.
Case based discussions (CbDs) are a mandatory workplace assessment used throughout general practitioner (GP) specialty training; they contribute to the annual review of competence progression (ARCP) for each trainee. This study examined the judgements arising from CbDs made by different groups of assessors and whether or not these assessments supported ARCP decisions. The trainees selected were at the end of their first year of GP training and had been identified during their ARCPs to need extra training time. CbDs were specifically chosen as they are completed by both hospital and GP supervisors, enabling comparison between these two groups. The results raise concern with regard to the consistency of judgements made by different groups of assessors, with significant variance between assessors of different status and seniority. Further work needs to be done on whether the CbD in its current format is fit for purpose as one of the mandatory WPBAs for GP trainees, particularly during their hospital placements. There is a need to increase the inter-rater reliability of CbDs to ensure a consistent contribution to subsequent decisions about a trainee's overall progress.
基于案例的讨论（CbDs）是全科医生（GP）专科培训中使用的一项强制性工作场所评估；它们有助于对每位学员的能力进展进行年度审查（ARCP）。本研究考察了不同评估者群体进行的基于案例的讨论所产生的判断，以及这些评估是否支持ARCP决策。所选学员处于GP培训的第一年末，并且在他们的ARCP期间被确定需要额外的培训时间。特别选择基于案例的讨论是因为医院和GP督导都会完成这些讨论，从而能够在这两组之间进行比较。结果引发了对不同评估者群体所做判断一致性的担忧，不同地位和资历的评估者之间存在显著差异。关于当前形式的基于案例的讨论作为GP学员强制性工作场所评估行为（WPBAs）之一是否适合其目的，尤其是在他们医院实习期间，还需要进一步开展工作。有必要提高基于案例的讨论的评分者间信度，以确保对学员整体进展的后续决策做出一致贡献。
