Assessing general practice clinical decision making skills: the key features approach.

The key feature problem (KFP) is an innovative assessment format that tests clinical decision making skills by focussing on only the critical steps -- or 'key features' -- of each decision, thereby increasing the number of problems that can be answered in a 3 hour examination. It has been used successfully in The Royal Australian College of General Practitioners Examination for Fellowship and is gaining in popularity in other high stakes testing settings. This article describes how the KFP paper is designed and constructed, how the pass mark is set, and how the approach performs.