Membership of the Royal College of General Practitioners (MRCGP) Workplace-Based Assessment (WPBA) and Professional Development Syllabus

What is the mini-CEX, and in which training setting is it typically used in GP training?

The mini-Clinical Evaluation Exercise: a tool for directly observing a trainee's focused clinical encounter with a patient, providing immediate structured feedback. In GP training it is the equivalent used during hospital (secondary care) placements, with the COT used in the GP/community setting.

What is the key difference between the COT and the mini-CEX in terms of setting?

The COT is used in the general practice (primary care) setting, while the mini-CEX is used in the secondary care/hospital component of GP training; both observe real consultations and give structured feedback.

What is Multi-Source Feedback (MSF), also known as 360-degree feedback?

A tool that collects structured feedback on a trainee's performance and professional behaviour from a range of colleagues (clinical and non-clinical) and sometimes patients, to give a rounded view of attitudes and teamworking.

In MSF for GP training, roughly how many respondents and of what mix are typically required?

Usually around 5 clinicians plus 5 non-clinicians (or a defined minimum of clinical and non-clinical colleagues), completed at specified points in training to ensure a balanced, valid sample.

What is a Patient Satisfaction Questionnaire (PSQ) in WPBA used to evaluate?

Patients' views of the trainee's consultation and interpersonal skills (e.g. communication, empathy, involvement in decisions), gathered from a sample of consecutive patients to assess the patient's perspective on care.

What does CEPS stand for in WPBA?

Clinical Examination and Procedural Skills.

What is the purpose of CEPS assessments?

To provide evidence that a trainee can competently and safely perform clinical examinations and practical procedures, including obtaining consent, maintaining dignity, and following infection-control standards.

Name the five 'mandatory' intimate/specific examinations often evidenced under CEPS.

Breast examination, female genital examination, male genital examination, rectal examination, and prostate examination (intimate examinations that must be evidenced as competently performed).

Define 'clinical audit' in general practice.

A quality improvement process that systematically reviews care against explicit standards/criteria and implements change, then re-measures to confirm improvement (closing the loop).

What are the stages of the clinical audit cycle?

1) Identify a problem/set standards and criteria; 2) Collect data on current practice; 3) Compare against the standard; 4) Implement change; 5) Re-audit/re-measure to close the loop.

What distinguishes Quality Improvement (QI) from a traditional clinical audit?

Audit measures performance against a fixed standard at intervals (often a two-point loop), whereas QI uses continuous, iterative small-cycle change (e.g. PDSA cycles) with ongoing measurement to drive improvement over time.

What does the PDSA cycle stand for in quality improvement?

Plan, Do, Study, Act — an iterative four-step model for testing and implementing small-scale changes.

What is a Quality Improvement Project (QIP) as required in GP training?

A trainee-led project applying QI methodology (e.g. PDSA cycles) to a chosen area of practice, demonstrating measurement, change implementation, and reflection on improvement, replacing the older audit requirement in many schemes.

What is the role of the Clinical Supervisor (CS) in GP training?

The doctor (often the GP trainer or a hospital consultant) responsible for the trainee's day-to-day supervision in a specific post, providing direct teaching, support and a Clinical Supervisor's Report (CSR) at the end of the placement.

What is the role of the Educational Supervisor (ES) in GP training?

A trained GP responsible for the trainee's overall educational progress across the whole programme, conducting regular ES reviews, reviewing the ePortfolio evidence, and making holistic judgements on progress.

What is the Educational Supervisor's Review (ESR) and how often is it typically conducted?

A structured review where the ES evaluates the trainee's progress across all 13 capabilities using the ePortfolio evidence, usually conducted approximately every six months, to inform the ARCP.

What is a Clinical Supervisor's Report (CSR)?

A structured report completed by the clinical supervisor at the end of a placement (especially hospital posts) giving feedback on the trainee's performance, used as evidence within WPBA and the ESR.

Define 'structured reflection' in the context of GP learning logs.

A deliberate, written analysis of an experience that explores what happened, the trainee's feelings/reasoning, what was learned, and how future practice will change — going beyond mere description to demonstrate insight.

Name a commonly used reflective model with the stages 'Description, Feelings, Evaluation, Analysis, Conclusion, Action Plan'.

Gibbs' Reflective Cycle (1988).

What is the purpose of learning logs in the GP ePortfolio?

To record and reflect on learning experiences (clinical cases, tutorials, courses, reading, significant events), demonstrating evidence across the curriculum capabilities and showing reflective practice and learning needs.

What does PDP stand for, and what is its purpose?

Personal Development Plan. A structured plan that identifies a trainee's learning needs, sets specific objectives and actions to address them, with timescales and review dates, to direct and document self-directed learning.

What framework is recommended for setting effective PDP learning objectives?

SMART objectives — Specific, Measurable, Achievable, Relevant, and Time-bound.

Define a 'Significant Event' in the context of Significant Event Analysis (SEA).

Any event, positive or negative, that is thought to be significant in the care of patients or the conduct of the practice, which is collectively analysed to learn and improve care.

What are the typical stages/steps of a Significant Event Analysis?

1) What happened (description); 2) Why did it happen (analysis of contributing factors); 3) What was learned (insight); 4) What has been/will be changed (action and follow-up to prevent recurrence).

What is the difference between a 'systems-based' and a 'person-based' approach to learning from errors?

A systems (or systemic) approach focuses on the conditions and processes that allowed an error, designing safeguards to prevent recurrence; a person-based approach blames individuals. The systems approach is favoured in modern patient-safety culture.

Define 'duty of candour' in UK medical practice.

The professional and legal obligation to be open and honest with patients (or their carers) when something goes wrong with their care that has caused, or could cause, harm — including apologising and explaining what happened.

What is 'appraisal' for a UK doctor and how often does it occur?

An annual, formative, structured professional conversation reviewing a doctor's whole scope of practice against GMP, using supporting information and reflection to support development and inform revalidation. It occurs once per year.

What is 'revalidation' and how frequently does it occur for UK doctors?

The process by which licensed doctors demonstrate to the GMC that they are up to date and fit to practise, normally occurring every five years, based on the recommendation of a Responsible Officer drawing on annual appraisals.

Who makes the revalidation recommendation to the GMC for a doctor?

The Responsible Officer (RO), usually a senior doctor in the doctor's designated body, who reviews the doctor's appraisals and supporting information before recommending revalidation.

What are the six types of supporting information required for a UK doctor's appraisal and revalidation?

1) Continuing professional development (CPD); 2) Quality improvement activity (e.g. audit/QIP); 3) Significant events; 4) Feedback from colleagues (MSF); 5) Feedback from patients; 6) Review of complaints and compliments.

What is the ARCP in the context of GP specialty training?

The Annual Review of Competence Progression: a formal annual panel review of all the trainee's WPBA and assessment evidence to confirm satisfactory progress and decide whether the trainee can progress, needs more time, or other outcomes.