above. Ease of operation of the system would allow doctors to undertake self-assessment on an open access basis. Computer-assisted self-assessment was well received both by those who were self-selected and by those who were not (table II). Most users enjoyed the programs and comments were volunteered such as "very enjoyable and helpful," "a salutary experience," and "not intimidating," although a few considered it to be "of uncertain benefit" and "of limited value." The programs were designed to simulate real clinical problems which the participants had to consider and evaluate before replying so that they became actively engaged in the selfassessment/teaching process. The scores for each question from each user could be rapidly retrieved and analysed, unlike printed programmed texts. The method now requires a more extensive trial to determine how effectively it can be used throughout the country. The programs, however, have been sent by post to several other centres where they were used without direct guidance from us and the responses from such centres have been equally favourable. Of the two scoring systems used, the simpler 1-3 scale was more popular, but the 1-5 scale may permit more discrimination when dealing with situations demanding clinical judgments, and there is no absolute correct answer. In conclusion, computer-assisted self-assessment combines the function of continuing postgraduate education and quality assurance. It would appear to be able to differentiate between varying levels of knowledge. It was acceptable to most of the anaesthetists who took part, and information may be obtained and analysed readily. It may offer a possible solution to the requirements for a method of quality assurance in anaesthesia and in other specialties. The quality of the assessment programs is of major importance in determining this aspect of quality assurance, and the mechanism for achieving acceptable standards of programs would be a matter for debate within the specialties concerned.
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