title: Competence-based assessment of specialist registrars: evaluation of a new assessment of out-patient consultations.
abstract: OBJECTIVE
  To implement and evaluate formal assessment of the performance of West Midlands rheumatology specialist registrars (SpRs) in conducting out-patient consultations.
  
  
  METHODS
  SpRs conducted a full out-patient clinic while being observed by one or two consultants who scored each SpR's performance on a structured pro forma. The assessment was conducted within the examining consultant's hospital trust (in which the SpR was not working). The process was evaluated by trainees and trainers by means of a questionnaire.
  
  
  RESULTS
  Sixteen SpRs were assessed. No trainee failed to reach the required standard. Six trainees scored 'borderline' for management planning and four had a borderline performance recorded for examination skills. Overall the process was valued by trainers and trainees, although consensus was that it would be more practicable for the trainee to be examined within the hospital in which they were working by a visiting consultant examiner. It was also felt that a broader range of scoring options would be preferable.
  
  
  CONCLUSIONS
  Formal assessment, by direct observation, of the skills of SpRs in conducting an out-patient clinic is practicable and offers information which is useful to trainer and trainee. A culture of direct observation of performance can be achieved within the context of rheumatology higher medical training.
authors.affiliation: Staffordshire Rheumatology Centre, Haywood Hospital, High Lane, Burslem, Stoke-on-Trent ST6 7AG, UK. Caitlyn.Dowson@uhns.nhs.uk
authors.forename: C
authors.initials: C
authors.lastname: Dowson
authors.forename: A
authors.initials: A
authors.lastname: Hassell
mesh_terms: D000553:Ambulatory Care / Q000592:standards; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education; D004503:Education, Medical, Graduate / Q000379:methods; D004521:Educational Measurement; D004739:England; D006801:Humans; D008487:Medical History Taking / Q000592:standards; D008505:Medical Staff, Hospital / Q000193:education*; D010808:Physical Examination / Q000592:standards; D012017:Referral and Consultation; D012219:Rheumatology / Q000193:education*