Vic’s guide to success in workplace based assessment

Vic’s guide to success in workplace based assessment

or..... you have been warned

Dr Vic SchrieberAssociate Dean / Area Programme DirectorHerefordshire & Worcestershire GP educationvic.schrieber@westmidlands.nhs.ukwww.hwgpe.org.uk Programme Administrator Kate Faulkner-Elliott kate.faulkner-elliott@rcgp.org.uk 0121 414 8275

Your aim is to become a safe, effective general practitioner To achieve that, you must gain MRCGP and certification of completion of training

MRCGP & CCT External (RCGP)Applied Knowledge TestClinical Skills Assessment Internal (ES & ARCP) Workplace Based Assessment Each of the components is of equal importance You must pass all three

This isn’t about CSA & AKT but... • Aim to take AKT towards end of ST2 • Most who are due to finish in August go for CSA in February/March

Workplace Based Assessment • Record is eportfolio • You need to • Register • Use a sensible email address • Ideally nhs.net or doctors.org.uk • Engage • Make regular, reflective entries • Share with supervisor

Workplace Based Assessment • Case Based Discussion • Consultation Observation Tool /Mini-CEX • Directly Observed Procedural Skills • Multi-Source Feedback • Patient Satisfaction Questionnaire • Learning Log • Professional Development Plan

Workplace Based AssessmentCase based discussions (CBD) • Six in ST1 & 2, twelve in ST3 • Should be reasonably challenging cases • Your supervisor will probably concentrate on two competencies, not all twelve • Expect grade of needs further development in ST1 – competent ( or even excellent ) comes later

Workplace Based AssessmentConsultation observation tool (COT) • Twelve in ST3, three in GP ST2 post • Should be reasonably challenging cases • Can be video-recording or direct observation e.g. in joint surgery • In general practice only; replaces mini-CEX in hospital posts

Workplace Based Assessment Mini - CEX (in hospital posts) • Three in each hospital post in ST1 & 2 • Observation of a clinical episode of care • Often be your consultant assessing • Might be a registrar or a senior nurse • In general practice it is replaced by COT

Workplace Based AssessmentDirect Observation of Procedural Skills (DOPS) • Eight mandatory, eleven optional • Try to complete opportunistically during ST 1 & 2 hospital based posts • Must be supervised by senior clinician – preferably consultant, experienced SpR, staff grade or specialist nurse rather than peer or foundation doctor.

Workplace Based AssessmentMulti-source feedback • Once in ST1 & again in ST3 • Five clinicians • Each answers two questions. • Assessment of your overall professional behaviour • Assessment of your overall clinical performance

Workplace Based AssessmentPatient satisfaction questionnaire • Once in GP ST2 post and again in ST3 • Handed out to consecutive patients until 40 responses achieved • Results added electronically to RCGP website by practice staff • RCGP produces a report that appears in your ePortfolio

Workplace Based AssessmentLearning log • At least two , preferably three, entries per week • At least one clinical • Quality more important than quantity • Use whole range- e.g. SEA, audit • Ensure reflection • Complete all the boxes • Sensible curriculum linkage

Workplace Based AssessmentLearning log • At least two , preferably three, entries per week • Do them at the time; don’t save them until you have loads to enter • You can’t expect your ES to wade through weeks and weeks of old learning log entries at one sitting

Workplace Based AssessmentLearning log • Complete all the boxes • What will you do differently in future? • What further learning needs did you identify? • How and when will you address these?

Workplace Based AssessmentLearning log • Sensible curriculum linkage • Two or three is enough – more than six is suspicious • Women’s Health means more than a female patient • Likewise Men’s Health & Care of Older Adults • Evidence relating to the curriculum area

Curriculum coverage When you make a new entry to your log you have the opportunity to select the most appropriate curriculum headings from the pick list and thereby indicate which parts of the curriculum you think you are addressing. When linking to curriculum headings take care to look at the learning objectives in the relevant curriculum statement and ask yourself: - does my log entry provide evidence that relates to the specific learning objectives in this statement? Although in many cases an individual entry may merit more than one curriculum heading, try to ensure that you don’t choose inappropriate ones.

Curriculum coveragean example • You add a learning log entry • A clinical encounter about your care in A & E of a 78 year old woman admitted with haematemesis • Curriculum linkage? • Care of acutely ill people ..... fine • Digestive problems ....... OK too • But not.....Care of older adults • Nor ..........Women’s Health

Curriculum coverage • Although, if you were looking after the same 78 year old woman on a medical ward • Your entry might be a clinical encounter about your decisions for treatment in view of her co-morbidities • Curriculum linkage? • Care of older adults..... Fine • Digestive problems ....... OK too • Patient safety................Possibly • Still not ..........Women’s Health

Are you a reflector? • Being a reflective General Practitioner • available from the Deanery website as is • A Friendly Guide to e-Portfolio and ARCP • ARCP Information Sheet

Workplace Based AssessmentPersonal development plan • Update regularly, every month or two • Review previous entries to ensure cycle complete • Add new entries • SMART • What you need to do to improve your learning • NOT what you have to do (such as pass AKT) • Ensure reflection

Workplace Based AssessmentPersonal development plan • SMART • Specific • Measurable • Achievable • Realistic • Timely

Workplace Based AssessmentEducators’ notes • Keep a regular check on this • Your ES, TPD and others will use it as a record for important information that is visible to all • e. g. Sick leave, poor compliance with advice • Everyone is trying to help, so...... • It makes sense to comply with any advice given

Haveyou signed all the statutory declarations? • Probity: Professional Obligations • Probity: Convictions and disciplinary actions • Health: Professional Obligations • Health: Regulatory and voluntary proceedings • Educational Agreement

Other requirements • Valid CPR and AED Certificate • Out of Hours Session requirements • Safeguarding children • Audit

Out of Hours • Minimum of 72 hours • Organise induction in ST2 • Harmoni in Worcestershire, Primecare in Herefordshire • Do some in ST2 – up to 24 hours – less pressure in ST3 • EWTD issues

Clinical Supervisor Review • One for each post in ST 1 & ST 2 • Up to you to organise • Best done in good time for ESR/ARCP

Educational Supervisor Review • Every six months • Up to you to organise but, if your ES offers a date & time, take it • December and May for most but depends on your year end / CCT date • Between eight and two weeks before the ARCP panel

Educational Supervisor Review • You must complete a self-assessment in each of the 12 competency areas before each review • ES will review & make a rating on those competency areas with evidence-based comments • ES will comment on your curriculum coverage, your skills log and the quality of the evidence presented in the ePortfolio • Finally, ES makes an overall judgement on your progress • If concerned, ES will refer you to ARCP panel (though the panel will review even when ES says satisfactory)

ARCP panels • The main panel is held in June or July each year as, for most, the year end is in August • For registrars who are out of phase there are panels held every two months, Aug, Oct, Dec, Feb & Apr • The relevant panel for you will be the one that is within eight weeks of your year end

ARCP panels You may receive notification via the eportfolio but you should contact your Area Programme office kate.faulkner-elliott@rcgp.org.uk to ensure that you are listed. Remember your progress through training depends on the ARCP panel.

ARCP panels • The purpose of the ARCP panel is • Check that adequate evidence has been presented. • If adequate evidence has been present then to make a judgement about the trainee's suitability to progress to the next stage of training or confirm training has been satisfactorily completed. • The evidence presented is through the e-portfolio. The aim of the ARCP panel is to help and support a trainee's progress through their training programme, by assessing the evidence presented, making judgement on that evidence and then recommending an outcome.

ARCP panels • The ARCP panel process ensures careful review of all eportfolios to check that all tasks have been achieved and that entries are suitably thorough and reflective. • The judgements are made by an external panel (from another part of the West Midlands rather than Herefordshire or Worcestershire).

ARCP panel outcomes • The panel can make a number of decisions or outcomes • Outcome 1 Satisfactory Progress • Outcome 2 Unsatisfactory progress - additional training time not required. • Outcome 3 Unsatisfactory Progress - additional training required. • Outcome 4 Released from training • Outcome 5 Insufficient evidence presented. • Outcome 6 Gained all competencies required • Outcome 7 Fixed Term Speciality Trainee • Outcome 8 Out of programme for research approved clinical training or Career Break

ARCP panels • Most trainees will be judged to be making satisfactory progress or have completed training successfully. • Information should be available on the eportfolio shortly afterwards. • Those with unsatisfactory outcomes may be required to attend for an interview on the day of the panel • You must ensure that you are available on that day • Remember that your career may depend on it.

Some words of comfort • Most trainees sail through WPBA & ARCP panels without any problems • All it needs is for you to succeed is to keep a regular and timely record of some of the interesting things that you have learned

Some words of warning • Make frequent and regular entries • Do more than the minimum • Respond to advice • There are number crunchers who will be counting

Some words of warningfor ST3s • If your year end is August, you really do need to complete everything by May • So anything that you can do in ST2 (like pass AKT and some OOH sessions) will help to reduce the pressure

Remember Unless you record the evidence of your learning, you cannot be credited with it

The TEN Eportfolio Pearls(with thanks to Yorkshire & Humberside Deanery) • Don’t get hung up on where to put what. • Write what would be helpful for you; something worthwhile and you don’t want to forget. • Record information at two levels – the general and the specific. • Recording your feelings is good. • Try to write in your natural style

The TEN Eportfolio Pearls 6 Visit the e‐portfolio regularly: making entries in a timely way AND reviewing the “whole picture” REGULARLY • It’s all about quality not quantity • Don’t forget to make effective use of your PDP • The minimum numbers of assessment are THE MINIMUM, you should be doing lots more. • Don’t miss any of your Educational Supervision sessions

Thank you for your attention Questions?

Vic’s guide to success in workplace based assessment