An assessment centre model based on the rating of non-technical skills can produce a reliable and valid selection tool for recruitment to speciality training in anaesthesia. Early results on predictive validity are encouraging and justify further development and evaluation.

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Interprofessional point of care or in situ simulation is used as a training tool in our operating theatre directorate with the aim of improving crisis behaviours. This study aimed to assess the impact of interprofessional point of care simulation on the safety culture of operating theatres. A validated Safety Attitude Questionnaire was administered to staff members before each simulation scenario and then re-administered to the same staff members after 6-12 months. Pre- and post-training Safety Attitude Questionnaire-Operating Room (SAQ-OR) scores were compared using paired sample t-tests. Analysis revealed a statistically significant perceived improvement in both safety (p < 0.001) and teamwork (p = 0.013) climate scores (components of safety culture) 6-12 months after interprofessional simulation training. A growing body of literature suggests that a positive safety culture is associated with improved patient outcomes. Our study supports the implementation of point of care simulation as a useful intervention to improve safety culture in theatres.

-Clinical problem solving tests (CPSTs) have been shown to be reliable and valid for recruitment to general practice (GP) training programmes. This article presents the results from a Department of Health-funded pilot into the use of a CPST designed for recruitment to the acute specialties (AS). The pilot paper consisted of 99 items from the validated GP question bank and 40 new items aimed specifically at topics of relevance to AS training. The CPST successfully differentiated between applicants. The overall test and the GP section showed high internal reliability, whereas the AS pilot section performed less well. A detailed item analysis revealed that the AS pilot items were, on average, more difficult and of poorer quality than the GP items. Important issues that need to be addressed in the early development phase of a test used for high stakes selection to specialty training programmes are discussed. Subsequent research has shown the machine marked tests (MMTs) used in GP selection are as valid and reliable as the current standard shortlisting method of scoring application form questions. 2 In light of this, this article presents the preliminary results from an ongoing Department of Health-funded pilot study of the development of a clinical problem solving test (CPST) tailored to the acute medical specialties, looking specifically at its reliability, content validity and face validity. The initial pilot testThe CPST paper consisted of 139 items mapped onto the foundation programme curriculum: 99 taken from the GP bank of validated items and 40 newly written items aimed specifically at topics of relevance to acute specialty (AS) training. The tried and tested GP items provided a useful benchmark against which to assess the performance of the newly developed AS items. The new items were written by a group of subject matter experts, including consultants in acute medicine, anaesthesia, emergency medicine and intensive care medicine.Applicants attending selection centres in 2008 at the South West Peninsula Deanery for CT1 training posts in anaesthesia, core medical training and the acute care common stem (ACCS) were invited to sit the first pilot CPST. Participation (or not) did not influence selection outcome in any way and participants consented to the linking of test results with other personal data. The paper was administered on the day of interview and an overall response rate of 74% (125 of 169 applicants) was achieved. Reliability of the testThe distribution of test scores was approximately normal in each section (GP and AS), indicating an absence of ceiling or floor effects and showing that the test has the potential to differentiate between candidates. Both the overall test and the GP item section showed very high internal reliability (Cronbach's ␣ϭ0.90 and 0.92 respectively). The AS pilot section performed less well (␣ϭ0.43), though this is partly attributable to the smaller number of items used. When corrected for test length (Spearman-Brown), the expected reliability of a 99-item test of equ...