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Educ Prim Care. 2019 May;30(3):167-172. doi: 10.1080/14739879.2019.1570476. Epub 2019 Feb 6.

A description and evaluation of an educational programme for North West England GP trainees who have multiple fails in the Clinical Skills Assessment (CSA).

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a SOX Programme, Health Education England North West , Manchester , UK.


Background and aims: Trainees who have failed the Clinical Skills Assessment (CSA) component of the Membership of the Royal College of General Practitioners (MRCGP) licensing examination present an educational challenge. This study describes a CSA resit programme and evaluates the outcomes when doctors reattempt the CSA. Methods: We delivered an educational programme to trainees in North West England who were resitting the CSA in 2016 and 2017: the majority were undertaking periods of additional training time. After the programme, we compared their CSA pass rates with national pass rates. Results were stratified by the number of previous attempts and source of primary medical qualification. Results: The trainees who took part in this programme had pass rates that exceeded national pass rates. Results were particularly encouraging for the group of International Medical Graduates (IMGs) who had previously failed the CSA two or more times. Conclusions: We suggest several possible explanations for these results. All trainees reappraised their learning needs, using educational tools written by CSA assessors. The programme was delivered by experienced, trained educators working with both trainee and trainer in order to produce shared educational plans. The training community's commitment to support trainees improved their confidence and motivation.


Clinical Skills Assessment (CSA); International Medical Graduates (IMGs); North West England CSA toolkit; prevention of additional training time (ATT); trainer-trainee relationship

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