Assessing Competence of NHS Consultants: Challenges and Possible Solutions

Even a mention of formal assessment of senior clinicians can be a contentious issue, to say least, when revalidation is said to be firmly in place in NHS-UK for almost half a decade. Since revalidation is accepted as a standard modality of assessment of performance, some colleagues in NHS wonder ‘stir up a hornets’ nest,’ when the authors allude to limitations of revalidation because poorly performing senior NHS clinicians may ‘slip through the net.’ NHS consultants have clinical as well as training roles. Fundamentally, this assessment (revalidation) is meant to ensure the safety of the public and mitigates the risk of disciplinary action by the GMC. Unfortunately, a disciplinary action is often the first sign of underperformance. In fact, the Bristol and Shipman inquiries have underscored the importance of the non-clinical and behavioural skills like communication, teamworking, personal organization and leadership are as important as clinical skills. Rather than considered an assessment tool, an annual appraisal is aimed to facilitate and improve the way NHS consultants work and provide services. The authors have to wait for five years, to assess the efficacy of the system that was introduced with much ‘fanfare’ since it was projected as a panacea for poor performance by ’bad doctors.’ The objectives of this article are to contextualize the issue of the underperformance among senior clinicians in the current NHS environment and to conceptualize the idea that their performance as trainers is directly related to their performance as clinicians. It is worth identifying the underlying factors of that are related to, or even better, can predict underperformance and will help evolve a strategy to help those consultants who are underperforming

A Combination of Teacher-Led Assessment and Self-Assessment Drives the Learning Process in Online Master Degree in Transplantation

Background: Good performance in a summative assessment does not always equate to educational gain following acourse. An educational programme may focus on improving student’s performance on a particular test instrument.For example, practicing multiple choice questions may lead to mastery of the instrument itself rather than testing theknowledge and its application. We designed an assessment strategy that consistently valid and reliable that would fitwith the students with a range of 27 nationalities with a different institutional, cultural and educational background inthis totally online masters programme in transplantation.Methods: Based on the published evidence, we analyzed 2 main assessment domains: (a) self-assessment and (b)peer-assessment. We compared them with traditional teacher-led assessment considering the diversity of students.Conclusion: We conclude that traditional teacher-led assessment supplemented by self-assessment is a strong drivein the learning process in this on-line course, whilst peer-assessment is challenging and associated with many flawsgiving the diversity of our students. Peer-assessment may be unreliable and not valid due to the difference in theinstitutional background and variation in experience between the students.</jats:p

On the Commutative Equivalence of Context-Free Languages

The problem of the commutative equivalence of context-free and regular languages is studied. In particular conditions ensuring that a context-free language of exponential growth is commutatively equivalent with a regular language are investigated