Abstract
BACKGROUND: The simulated surgery was developed to examine the consulting skills of general practice (GP) registrars by observing their consultations with standardized patients. It was introduced in 1997 as an alternative to videotape submission in the consulting skills component of the Membership of the Royal College of General Practitioners (MRCGP) examination for those candidates who are unable to prepare a videotape. AIM: To describe the methodology of the examination and to report on the first year's experience. METHOD: The development of the cases and the techniques of marking and standard setting in the simulated surgery are described. RESULTS: Thirty-eight GP registrars took part in pilot examinations and 37 candidates were examined for the MRCGP. The distribution of their marks and the resulting pass/fail decisions are reported. The reliability of the 20-case simulated surgery, using Cronbach's alpha coefficient, is greater than 0.85. CONCLUSION: The simulated surgery is a feasible, valid, and reliable examination of consulting skills. Cost and manpower requirements remain a problem, but these are being addressed by current plans.