PT  - JOURNAL ARTICLE
AU  - Anneke W Kramer
AU  - Koos J Jansen
AU  - Herman Düsman
AU  - Lisa H Tan
AU  - Cees P van der Vleuten
AU  - Richard P Grol
TI  - Acquisition of clinical skills in postgraduate training for general practice.
DP  - 2003 Sep 01
TA  - British Journal of General Practice
PG  - 677--682
VI  - 53
IP  - 494
4099  - http://bjgp.org/content/53/494/677.short
4100  - http://bjgp.org/content/53/494/677.full
SO  - Br J Gen Pract2003 Sep 01; 53
AB  - BACKGROUND: Postgraduate training in general practice aims to develop clinical competence. However, little is known about its effect on trainees' development of clinical skills. AIM: To assess the acquisition of clinical skills during a 3-year training programme and to evaluate whether a satisfactory level is achieved towards the end of training. DESIGN OF STUDY: Cross-sectional design. SETTING: Dutch postgraduate training in general practice from 1995 to 1998. METHOD: Clinical skills were assessed using a written knowledge test of skills and by an Objective Structured Clinical Examination (OSCE). The written test was administered to trainees in all 3 years. Trainees at completion of their training took the OSCE. The results of both tests were compared with a standard of adequacy and to a reference group of general practitioner (GP) trainers. RESULTS: An increase in the level of clinical skills and pass rate was found throughout the training, being most prominent during the first 6 months. At completion of their training, trainees scored higher than the GPs on the written test (48% versus 39%) and on the OSCE (69% versus 63%). Eighty-eight per cent of the trainees would have passed the written test against 70% of the GPs and 94% would have passed the OSCE against 80% of the GPs. CONCLUSION: A 3-year postgraduate training period in general practice contributes to a satisfactory acquisition of clinical skills. Further research into when and where acquisition takes place, and the role of the GP trainer, is needed.