Blueprinting for clinical performance deficiencies--lessons and principles from the General Medical Council's fitness to practise procedures

The UK General Medical Council (GMC) in its regulatory capacity conducts formal tests of competence (TOCs) on doctors whose performance is of concern. TOCs are individually tailored to each doctor's specialty and grade.

To describe the development and implementation of an electronic blueprinting system that supports the delivery of TOCs.

A case study that describes the evolution of the GMC electronic blueprint including the derivation of its content and its functionality.

A question bank has been created with all items classified according to the competencies defined by Good Medical Practice. This database aids test assembly and ensures that each assessment maps across the breadth of the blueprint.

The blueprint described was easy to construct and is easy to use. It reflects the knowledge, skills and behaviours (learning outcomes) to be assessed. It guides commissioning of test material and enables the systematic and faithful sampling of common and important problems. The principles described have potential for wider application to blueprinting in undergraduate or clinical training programmes. Such a blueprint can provide the essential link between a curriculum and its assessment system and ensure that assessment content is stable over time.