- CBD summary template for trainees
- CBD mapping sheet
- CBD – a beginner’s guide (powerpoint)
- CBD on 2 sides of A4 for trainers
- What the CBD competencies mean?
- The WPBA4GP home page - understanding the competencies
- Managing medical complexity – what does it mean?
- Community Orientation – what does it mean?
- Hot tips for doing CBDs – for trainers
- CBD Question Maker for trainers
- CBD Question Maker for hospital consultants
- The WPBA4GP home page – specific questions for specific competencies
- CBD question guidance from RCGP
- CBD assessor self-rating scale – for trainers (for peer appraisal)
- CBD template for Sports & Exercise Medicine trainees only
- how do I add an assessment if I am not the nominated supervisor?
- Becoming a GP by Amar Rughani - a super book which helps you understand the MRCGP process and competencies better.
- more CBD resources here
A FAB VIDEO FROM GUILFORD VTS ON CBDs
WHAT IS THE POINT OF DOING CBDs?
THE CBD PROCESS
You need to do a MINIMUM of
- 3 CBDs per 6 months in ST1
- 3 CBDs per 6 months in ST2
- 6 CBDs per 6 months in ST3
Remember, this is the MINIMUM – you should aim to do lots more! In hospitals, CBD happens in the same cyclical way displayed above EXCEPT the trainee presents 2 cases from which one is selected (not three as in the diagram above).
CBD isn’t what most people understand by case discussion – it’s a formal, structured exercise which needs preparation by both trainee and educator. The discussion should be framed around the actual case and should not explore hypothetical events. Questions should be designed to elicit evidence of specific competences rather than testing knowledge.
The assessor may select 3 or 4 competencies to look at but others may select more. It depends on several factors such as the experience of the assessor in assessing CBDs and how ‘meaty’ the subject matter becomes. The competencies are:
- Practising holistically
- Data gathering & interpretation
- Making a diagnosis/decisions
- Clinical Management
- Managing medical complexity (trainees often struggle with this one)
- Primary care admin and IMT
- Working with colleagues and in teams
- Community orientation (trainees often struggle with this one – by the way, it’s difficult to get in hospital posts!)
- Maintaining an ethical approach
- Fitness to practise (trainees often struggle with this one)
The competences are graded on a clearly defined 4-point scale – we’d expect trainees to progress from ‘needs further development’ to ‘competent’, and rarely achieve ‘excellent’ which is a description of a mature practitioner
- Insufficient evidence: from available evidence, cannot be placed on a higher point of this developmental scale.
- Needs further development: Rigid adherence to taught rules or plans. Superficial grasp of unconnected facts. Unable to apply knowledge. Little situational perception or discretionary judgement.
- Competent: Accesses and applies coherent and appropriate chunks of knowledge. Able to see actions in terms of longer-term goals. Demonstrates conscious and deliberate planning with increased level of efficiency. Copes with crowdedness and is able to prioritise.
- Excellent: Intuitive and holistic grasp of situations. No longer relies on rules or maxims. Identifies underlying principles and patterns to define and solve problems. Relates recalled information to goals of present situation and is aware of the conditions for application of that knowledge.
Question: To be classed as ‘competent’, does the trainee has to satisfy every single one of the descriptors in the list for that competency?
Answer: No – the descriptors are just there to give you a general idea of the sort of thing which is required. It is always worthwhile having the competency descriptors in one hand and your CBD question maker list in the other. After you’ve asked the questions you’ve developed for the CBD case see how the trainee’s response fits in with the competency descriptors list.
The competency descriptors list can be downloaded from the downloads box above.