Assessments: Case-Based Discussion (CbD)

The CbD is a structured oral interview designed to assess your professional judgment in a clinical case.

They are used to examine your performance against various Capabilities and looks at how you made holistic, balanced and justifiable decisions in relation to patient care.

Your understanding and application of medical knowledge, ethical frameworks, ability to prioritise and how you recognised and approached the complexity and uncertainty of the consultation will be looked at.

Who can complete a CbD?

You choose who undertakes your CbDs but it is encouraged that you complete assessments with a range of assessors.

CBD's can be carried out in hospital by either:

• Your Clinical Supervisors (which is best practice and they should complete at least one CbD during each rotation)
• Doctors who are ST4 or above
• Specialist and Associate Specialist (SAS) doctors with equivalent experience who have met the GMC assessor requirements
• Within primary care placements in ST1/2, your assessors will be approved GP Clinical/Educational Supervisors who have met the GMC standards

How to set up a CbD within your Portfolio:

Please be aware that protected time is needed for the assessment and below are the steps to completing a CBD:

• Go to your Portfolio then find the CBD's & CATs section within the Educational assessments area
• Choose the relevant Request assessment option depending on your role at the time (when you are in primary care placements in ST1/2 you will use the CAT form which includes CbDs)
• You will see an option either to choose an invite from your contacts list by selecting the bullet point in their name or you can Invite a new colleague by entering their details
• You will be able to supply some details about the Case or include a personal message if you like but once you have entered the information you will need to hit Invite
• An email will then be sent to the invitee providing a login code for the assessor to use to complete the ticketed CbD assessment form

A few things to be aware of before the Assessment:

• The case should be one that you have managed independently - it is NOT appropriate to have received advice from another doctor for the consultation and then to be assessed on actions taken by that other doctor
• You need to share the clinical entry with your supervisor before the assessment so they can familiarise themselves with the case
• Before the assessment you will need to ensure that you have thought about/prepared which 3 - 4 Capabilities you believe this case represents as you will be discussing these areas during the assessment and is what your supervisor will grade you on. The Capabilities should not necessarily be those that you covered well, as more useful learning can be achieved by choosing areas that you found challenging. You also need to be aware of the Capabilities you have chosen in previous assessments to ensure you cover the range of Capabilities during your training
• Your supervisor can support you in case and Capability selection if you are unsure how to do this
• The RCGP has produced questions to support assessors in assessing the Capabilities and it would be useful for you have a look at these prior to your assessment. 

The CBD discussion/write up:

It should normally take no longer than 30 minutes for your discussion and your supervisor’s feedback.

During the discussion, if your supervisor feels any other Capabilities have been covered, these as well as the agreed upon Capabilities can be added to the assessment form.

Your supervisor will then complete the assessment form within your Portfolio and each of the discussed Capability areas will be graded.

Your supervisor will document their feedback on your performance and their justification for their grades as well as their recommendations for further development.

Some assessors will have full access to your Portfolio but in non-primary care settings you may need to send them a ticket code to enable the assessment form to be completed. In this situation, having ideally agreed a mutually appropriate time to complete an assessment, it is preferable to send the ticket code in advance to your assessor.