Lifelong learning and assessment of skills of clinicians in clinical practice – Revalidation

Abstract

Life-long learning and assessment of clinicians with constructive feedback aim to maintains and improve standards of healthcare. With continually increasing introduction of newer diagnostic and therapeutic modalities in craft disciplines and increasing concerns regarding patient safety, it is imperative to keep training and assessment standards high in order to achieve excellence in patient care and to keep professional integrity. General Medical Council is in the process of implementing the process of revalidation in order to achieve these goals. However, the questions regarding the contents, feasibility, acceptability, validity and reliability of assessment process and lifelong learning remain unanswered. The aim of this work is to: (1) Seek opinions of specialists about the contents and acceptability of recertification (qualitative evaluation) and life-long learning (quantitative evaluation); (2) Explore the tools available for assessment of technical skills (systematic review); (3) Develop and validate a tool for evaluation of non-technical skills of both specialists and juniors during the ward rounds (observational studies); and (4) Delineate a process for evaluation of technical and non-technical skills of specialists and junior doctors based on clinical outcomes (meta-analysis). Observational tools have been identified for evaluation of technical skills in both simulated and real settings. Tools for assessment at both trainee and specialist levels were evaluated in terms of feasibility, acceptability, validity, and reliability. Using Failure Mode and Effect Analysis model (FMEA), a tool for assessment of non-technical skills of both trainees and specialists during the ward rounds was developed and validated for both simulated and real settings. Meta-analysis was carried out to propose a model for skills evaluation through technical and non-technical skills’ specific outcomes. Moreover, opinions of the specialists were collected and analysed through quantitative and qualitative methods to formulate recommendations for assessment of clinical practice For the first time in literature, feasibility and validity data for the process of assessment including specialists has been reported. This research has given recommendation to carry out further work to establish the effectiveness of the whole process of recertification and lifelong learning.