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TRAINING IN THE USE OF ICPC

Exercises of the book ICPC-1 (1987)

(coded with ICPC-2 codes)
Go to vignettes


There are several ways to train providers in the use of ICPC, depending on the circumstances and also on the aims of the project for which ICPC is being used. If an individual provider wants to become familiar with ICPC and its practical use, this book should be sufficient for this purpose. However, from experience with several recording projects in general practice it is known that most physicians have blind spots when using a classification system. A group of providers, cooperating in the same project, offers a good forum to discuss practical problems with the use of the classification and to prevent the consequences of structural misunderstanding.
Often ICPC will be used in a project where there is a program coordinator or principal investigator (PI) and several collaborating providers. The PI will be the most likely person to become the expert on ICPC and consequently responsible for training the rest of the group in the use of ICPC. Under these circumstances it can be helpful to follow the steps of the training process which by the experience from studies with ICPC have proven to be satisfactory and not too time-consuming.
  1. A short introduction is given to the group of participants in the project, not only on the structure of ICPC and its potential, but also on the reasons why the classification system suits the needs of the project. It is pointed out that ICPC is only a feasible tool and not a means in itself, the users should not be intimidated by the sheer volume of the book.

  2. The participants are encouraged to study the manual and the classification system and to familiarize themselves at least with the location in the book where specific information can be found.

  3. A general discussion in the group gives the opportunity for questions and for more detailed answers and explanations, stressing the fact that it is important to use the classification system correctly in order to guarantee the best possible end results after all the workwhich has to be done.

  4. A series of written vignettes describing patient-physician encounters are presented to the group. All participants are individually encouraged to indicate the essential elements of the encounter and to classify these with ICPC, using the encounter forms designed for the project. The results are discussed in the group, where it usually becomes evident that mistakes are being made, but also that sometimes several different solutions are acceptable. This often happens, either because the vignette itself is not quite clear, or because the limitation in the available information does allow for several plausible interpretations. At the end of this chapter eight vignettes, with their preferred solutions, are presented as illustrations. The encounter form of the Transition Project of the University of Amsterdam is used.

  5. The participants now record 10-15 consecutive routine encounters in their own practice on the encounter form and they classify these with ICPC. All forms are scrutinized by the program coordinator and a selection of the forms is discussed in the group.

  6. When available, audio or video cassettes with routine encounters, together with the corresponding encounter forms, can be introduced in the group. This approach can be useful when the reliability and the validity of the coding has to be ascertained.

  7. Once the project is under way, the coded encounter forms should be checked regularly for completeness and for mistakes. Timely feedback is essential. Especially when the study covers a longer period – for instance one year – regular output form the ongoing analysis of the collected data is very important to motivate the participants. This output can also be discussed in the group in order to prevent the potential fall in the reliability of the coded data an also to ensure an optimal congruence between the potential of ICPC and the goals of the project.