Analysis of videotaped consultations to certify competence.

The assessment of videotaped genuine consultations in order to provide feedback to the learner is now a well accepted part of postgraduate training for general practice. This article reports on a pilot study which investigates the adaptation of videotape assessment of genuine patient consultations as an alternative to the present simulated patient interview segments of the examination for Fellowship of the Royal Australian College of General Practitioners. In particular, the study addresses: the feasibility and cost of collecting and assessing a suitable range of videotaped consultations using portable videocamera equipment and remote examiners; the interobserver reliability of four independent examiners; and the correlation between scores on two different rating scales. The results demonstrate that the assessment of videotaped genuine consultations has the potential to become a means of end-point assessment of clinical competence. The problem of how to collect videotapes of a suitable range and number of consultations to permit a candidate to demonstrate proficiency needs to be addressed and will be followed up in a trial of the method during 1990.