The Future of Workplace Based Assessment Pauline Foreman Chief Examiner RCGP

The MRCGP Tripos MRCGP is the licensing assessment for UK GP Running in its current format for 10 years this year Blueprinted to the GP curriculum which is vast 3 components AKT ST2 onwards CSA ST3 onwards WPBA runs throughout our very short 3 year training programme By exit trainees have to demonstrate that they are competent in 13 competency areas On average Max 18 months spent in GP half of the training programme spent in secondary care posts with clinical supervision by secondary care supervisors

Purpose of WPBA Provides a framework for evaluating a doctor’s progress in those areas of professional practice best tested within the workplace Utilises multiple professional judgments and tools to develop a longitudinal view of a doctor’s performance Primarily an assessment for learning WPBA has a huge number of theoretical advantages/strengths as an assessment method It assesses at the top level of Miller’s pyramid what trainees are actually doing in practice & has huge face validity

Strengths Encourages structured observations of trainee’s performance in the work place Provides constructive feedback on areas of strength and developmental needs, identifying trainees who may be in difficulty Promotes reflective practice What’s not to like? There can be a disconnect between theory & practice In reality the experience can be less than satisfactory for both trainees and trainers

Issues Picking up trainees in difficulty at an early stage of training Assessment burden Lack of engagement

The Future GPCs Focus of assessment will be in WPBA On GPCs most commonly associated with fitness to practice issues Common language/assessment framework for all specialties SCAR Curricula & assessments will be outcomes based Focus on expert professional judgments Focus on Entrustable Professional Activities (EPAs)=Unit of Professional Practice that can be entrusted to a sufficiently competent learner

FTP Acting with honesty and integrity Leadership and team working Communication and interpersonal skills   Patient safety and quality improvement

EPAs vs Competencies

The Culture Ensure assessments provide useful information about a trainee’s progress. Right tools, right context, right judgments Look at outcomes/differential attainment (ITAP) Enhance training & benchmarking of assessors Engage trainees and assessors New developments/implementation Recognise the value of supportive training relationships Allow time for training

Ensure that this wonderful method of assessment reaches it’s full potential And that we reconnecting learning & assessment