Johnson N, Hasler J, Toby J, Grant J
Department of Public Health and Primary Care, University of Oxford.
Br J Gen Pract. 1996 Mar;46(404):140-4.
Summative assessment of general practitioner registrars is to be introduced in September 1996, one component of which will be a report by the trainer. Standards must be set and guidance provided as to the most appropriate ways of obtaining evidence for the trainer's assessment.
The first aim of this study was to set consensus minimum standards for 30 items that are likely to form the content of a trainer's report; the second aim was to provide a consensus view on the most appropriate methods of assessment to be used by trainers.
A consensus conference was held in March 1995 during which the 30 items were discussed by a group of 30 general practitioners, of whom 27 were experienced trainers. This resulted in a draft document that was circulated to the conference attenders and other experts for consultation.
Draft minimum standards were produced for all 30 items after the consensus conference with a mean of 2.5 standards for each item. Of those involved in the consultation exercise, 82% replied. Most of the revisions suggested at this stage were of a minor nature; the only major revision was to divide one item into two, resulting in a final total of 31 items. All but one of the 80 standards could be assessed by direct observation; 41 (51%) could be assessed by tutorial-based discussion and 61 (76%) by methods specific to that standard. Trainers or their practice partners were viewed as acceptable sources of evidence for all items and hospital consultants and primary health care team members were viewed as acceptable for just over half of the items.
Standards for use by trainers when providing a general practitioner report for the summative assessment of registrars have been developed by consensus conference and have been subjected to review by consultation. Acceptable methods by which registrars could be assessed against these standards, and suitable personnel who could provide evidence, have also been suggested.
1996年9月将引入对全科医生注册实习生的总结性评估，其中一个组成部分将是培训师撰写的报告。必须制定标准，并就获取培训师评估证据的最合适方法提供指导。
本研究的首要目的是为可能构成培训师报告内容的30项内容设定共识性最低标准；第二个目的是就培训师使用的最合适评估方法提供共识性意见。
1995年3月召开了一次共识会议，30名全科医生（其中27名是经验丰富的培训师）对这30项内容进行了讨论。这产生了一份文件草案，并分发给会议参与者和其他专家进行磋商。
在共识会议之后，为所有30项内容制定了最低标准草案，每项内容平均有2.5条标准。参与磋商的人员中有82%进行了回复。在此阶段提出的大多数修订都是小改动；唯一的重大修订是将一项内容分为两项，最终总共为31项内容。80条标准中除一条外，其余均可通过直接观察进行评估；41条（51%）可通过基于辅导的讨论进行评估，61条（76%）可通过针对该标准的特定方法进行评估。培训师或其执业伙伴被视为所有项目可接受的证据来源，医院顾问和初级卫生保健团队成员被视为略多于半数项目的可接受证据来源。
通过共识会议制定了培训师在为注册实习生的总结性评估撰写全科医生报告时使用的标准，并通过磋商进行了审查。还提出了根据这些标准评估注册实习生的可接受方法，以及可以提供证据的合适人员。
