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Leicester simulated patient surgery project
Guide lines for GP Registrars

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Application forms

 

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Guidelines for GP Registrars

Simulated Patient Surgery is an alternative to submission of a video (consulting skills element of Summative Assessment). Simulated Patient Surgery was pioneered by staff in the 'Yorkshire' and 'Leicestershire, Northamptonshire and Rutland'  Deaneries and is available to all GP registrars in the UK, with the permission of their Director.

When can GP Registrars do Simulated Patient Surgery?
GP registrars are advised that they should attempt Simulated Patient Surgery during the final six months of training in a GP practice. A GP registrar may submit an application form during the first six months of training in a GP practice but he or she must have the application endorsed by his / her trainer (that is, countersigned by the trainer). Similarly, if a GP registrar is in a so-called ‘combined post’ in his or her middle year, then the trainer must countersign the application.

GP registrars from deaneries other than Leicester need the signature of their Director of Postgraduate Medical Education (or Course Organiser) for General Practice before an application form be submitted. This is to confirm funding.

When and where are Simulated Patients Surgeries held?

  • Simulated Patient Surgeries are held in 'real' GP surgeries around
    the LNR Deaneries.
  •  Dates for surgeries will normally be between April to June inclusive
    and September to December inclusive but extra surgeries may be arranged as
    required.
  • Dates will be circulated during March and September of each year
    once it is known how many candidates there are for SPS. Candidates for SPS
    should submit their application forms by the 7th March or 7th September to
    be included in that six months for SPS.
  • Consultations for simulated surgery are only available in English.
  • It is vital that the potential applicants apply to the scheme
    administrator in     LNR

Training/Familiarisation/Information re Simulated Patient Surgery
Familiarisation sessions will also be arranged twice yearly and dates will be circulated during March and August each year. A team from Leicester will also, in some circumstances, be available to attend a particular deanery for familiarisation workshops.

How does a GP Registrar apply to do Simulated Patient Surgery?
A GP registrar should request/return an application form from/to the Administrator in LNR .

Following submission of application form

  1. When an application form is received into LNR, the GP registrar is allocated a surgery.
  2. A letter is sent to the GP registrar advising him or her of the date of the surgery, the venue, the start time & other details of the surgery. The candidate doctor is also requested to bring their usual diagnostic equipment to the examination (mandatory) as well as a copy of BNF or MIMS, if desired. If the Simulated Patient Surgery examination is taking place during the evening, the GP registrar is advised to take at least half a day off on that day. A map showing the location of the surgery and information for candidates will be enclosed.

    If the GP registrar cannot attend on the date given, he or she will be offered an alternative date.

    Please note, however, that as this is an examination, the GP registrar is expected to make every effort to attend and should inform the Administrator as to why he/she cannot attend.

What is the usual format of a Simulated Surgery?

  1. GP Registrars arrive and are met by the Supervising Doctor. The Supervising Doctor conducts a briefing session for approximately 30 minutes in which he or she answers any questions/concerns the candidate GP Registrars may have.
  2. Each candidate GP Registrar goes to his or her consulting room. Each candidate GP Registrar sees eight patient simulators during the surgery. The consultations last no longer than 10 minutes and the doctors have a break of 5 minutes between each consultation during which they have an opportunity to complete a ‘post-encounter sheet’. This enables them to note down their views on a particular consultation or, perhaps, detail how they may have done things differently. A normal surgery, therefore, lasts two and half-hours.
  3. Following each consultation with a candidate doctor each simulator completes a patient satisfaction sheet (rating scale) and a clinical checklist (a medical checklist, drawn up by a panel of GPs and phrased in lay terms).
  4. One consultation room and, therefore, one GP registrar may be videotaped during the surgery. This is for the purposes of quality control only (see below) and will not affect the outcome (success/failure) of a GP registrar’s consultations in any way. It will not, and cannot, be used as part of the marking process.
  5. At the end of the 8th consultation the doctors leave.

When are the results sent out following an Examination Surgery?
Candidates are informed within two weeks of their results (except during periods of office closure). A letter is sent to the GP registrars informing them if they have passed the surgery. A copy of this letter will also be sent to the host deanery.

What happens if a GP Registrar does not pass the first surgery?
Those who fail to demonstrate adequate consulting skills after one eight patient simulated surgery (pass six of eight consultations) are required to carry out a further eight-consultation surgery. There is no feedback available to doctors who do not pass the first simulated surgery prior to them sitting the second surgery.

Second Surgery
The GP registrar needs to pass sufficient consultations to give a pass rate of 11 out of 16 consultations over the two surgeries. If a pass is not achieved on the second surgery an expert panel takes a final pass-fail decision.

Please note – no one participating in the second surgery (patient simulators/supervising doctor/other GP registrars) is informed that a GP registrar is attending a second surgery.

Following the second surgery
If the candidate has passed, a letter will be sent informing the candidate and the host deanery.

What happens if a GP registrar does not meet the required standard during the second surgery?
An expert panel will meet to review the candidate’s marks at both surgeries. A pass/fail decision will then be taken. If a candidate fails overall then the matter is referred to the Director of the GP Registrar’s Deanery who will make a decision about whether a candidate should be permitted a period of further training.

How much does Simulated Patient Surgery cost?

  1. For GP registrars in the LNR Deanery the cost is met by the Deanery's summative assessment budget. Travelling expenses may also be claimed back from the Deanery.
  2. For GP registrars applying from deaneries other than Leicester, the total, one-off cost to the Deanery will be £150.00 (subject to change so please check). This will normally be paid by Deaneries when the Director’s signature has been obtained.

Making Payments
The LNR Deanery will raise an invoice and this will be sent to the host Deanery of the GP registrar(s).

Quality Control

  1. One consultation room and, therefore, one GP registrar may be videotaped during the surgery. This is for the purposes of quality control only and will not affect the outcome (success/failure) of a GP registrar’s consultations in any way. It will not, and cannot, be used as part of the marking process.
  2. The quality control video from each surgery is viewed and discussed by a Regional and/or Inter-regional Standards Setting/Expert Group. Their aim is to identify any inconsistencies/difficulties with particular roles (of patient simulators).
  3. When paperwork from a surgery is received into the LNR Deanery, the marks are fed into a customised Simulated Patient Surgery Database. This enables members of the Standards Setting Expert Groups to analyse each role and identify any inconsistencies/difficulties with any aspect of that role. Aspects of roles may be amended in light of this information.
  4. A quality control report will be sent to the PMETB on a regular basis.

Note: the quality control tapes, in accordance with the paperwork and, indeed, all material relating to summative assessment, will be destroyed twelve months after the registrar completes summative assessment.

 
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(Page last updated on 29/03/06)
 

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