Higher professional education

We wish to commend Patterson et al (March Journal)1 on their endeavour to describe a competency model for general practice. We fully support their view that it is important to be able to describe not only what we do but also what our patients want us to do. We are also gratified that they have provided further support for the validity of the component consultation competences contained within the Leicester assessment package which, although reported in the Journal six years ago,2 was not cited in this paper. We are dismayed that the authors’ literature review and your referees failed to identify this omission. Furthermore, the findings of a large corpus of education research over the past 20 years demonstrating that pencil and paper tests are poorly predictive of actual clinical performance were also overlooked. We would particularly take issue with the authors’ assertion that ‘psychometric tests ... [of] problem solving ... have good predictive validity’ for clinical problem solving ability. Van der Vleuten3 and Norman and Regehr4 summarise the powerful evidence against this assertion.