How the scheme works:

On the first working day of each month, a new distribution will appear on the website. Cases will reflect a range of complexity and include both general and specialist issues encountered by medical microbiologists and virologists. Participants will be alerted by email that the scenario is available.

Scenarios will typically represent a case study based on a real patient. Participants will be invited to suggest a diagnosis or a differential diagnosis, to recommend diagnostic interventions (both microbiological and non-microbiological, where appropriate), to interpret any results that are provided, to advise on therapeutic interventions and to identify any infection control and/or public health implications. The responses will be presented in a multiple-choice format. The scenarios will alternate monthly between those of a virological nature and those of a general bacteriological nature. Parasitology or mycology scenarios will be provided periodically; these will be at a level that is appropriate to microbiologists who are not specialists in these fields. There will also be occasional scenarios that specifically concern antibiotic susceptibility testing or antibiotic assays.

Participants will have one month to respond. Responses should be from individuals. Although consultation with colleagues is an important part of routine diagnostic practice, responses must be made without conferring as the maximum educational benefit is obtained when interpretive EQA schemes provide feedback on the opinions of individual participants, rather than those of their colleagues. Participants may choose not to respond to a particular scenario if it concerns a sub-speciality in which they do not practice. Participants will therefore be able to declare a case to be outside their normal practice (and should be prepared to justify this). To do this, a formal ‘out of scope’ response must be entered on the website within the normal response period; it cannot be entered retrospectively once the distribution has been closed.

On the day after the deadline, the intended answers (representing a consensus of members of the scheme panel), will be posted on the website. Individual reports, together with the anonymised responses of all of the participants and an educational commentary, will be available on the website approximately two weeks later. Participants will be alerted by email that the report is available.

Participants are expected to respond annually to at least 66% of distributions that they deem to be within the scope of their practice. (UK NEQAS should be informed of any long term absence from work leading to lower participation). An annual record sheet will be available to participants who respond to at least 66% of distributions. This may be used as evidence of participation, e.g. for laboratory accreditation.

Scoring and performance assessment:

In order to be eligible for scoring, answers to a question must achieve a consensus of 80% of participants (and there must also be no evidence that the popular response is incorrect). Individual reports will be produced for each participant following each distribution. These reports will show scores for individual questions and provide charts of performance rating and total scores from previous distributions (as provided for laboratory UK NEQAS EQA schemes). The annual record sheet will record participation and scores achieved for all distributions. It is envisaged that this report will be used by participants during their annual appraisal.

As part of an ongoing pilot, since January 2017, anonymised performance data from UK medical and scientist consultant participants will be reviewed by the National Quality Assessment Advisory Panel for Microbiology (NQAAP). NQAAP is responsible for promoting, coordinating and protecting high professional standards in EQA and encouraging the development of clinically relevant and appropriate EQA schemes. During the pilot, formal procedures will be established by UK NEQAS Microbiology and agreed with NQAAP. For the time being, the interpretative comments scheme will continue to be run without formal individual performance monitoring.

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