Changes in Training and Assessment

Training – a goal orientated activity

PMETB requirements ‘Effective systems are in place to assess whether individual doctors are progressing through training and have satisfactorily completed training’ ‘Throughout training, all assessments are appropriate, valid and reliable’

Previous system Educational supervisor ‘signs up’ trainee as competent Assessment evidence not always clear Not always clear how assessments are performed

Definition of Assessment ‘A systematic procedure for measuring a trainee’s progress or level of achievement against defined criteria to make a judgement about a trainee’

Principles of good assessment Objective, not subjective Summative and formative Valid, reliable and practical Multiple assessments Many assessors Judgements made at the time of encounter

‘Miller’s Triangle’ Does Performance Shows how Competence Knows how Knowledge Knows

Performance vs Competence Performance-based assessment measures what doctors do in their professional practice Competence-based assessment measures what doctors can do in controlled representations of professional practice

Areas for assessment Knowledge Skills Attitudes MCQ’s CbDs Mini CEX ACAT Attitudes Multi Source Feedback Patient/Carer survey

Multi Source Feedback Areas assessed Attitude to staff Attitude to patients Reliability & punctuality Communication with patients & families Communication with healthcare professionals Honesty & integrity (scored Y/N) Team player skills Leadership skills Overall professional competence

Patient Survey 10 questions Communication & respect 20 patients Same as used for consultants http://www.rcplondon.ac.uk/revalidation

Acute Care Assessment Tool Structured educational supervisor’s report Performance based Clinical Assessment, Record keeping, Investigations, Critically ill management Take management Teamworking, Leadership, Handover

Planned assessments

ST3 MRCP(UK) part 2 & PACES ALS up to date 6 acute Mini-CEXs 6 acute CbDs 1 ACAT Educational supervisor’s report

ST3 – RITA decision points MRCP(UK) part 2 & PACES, ALS absent = D Mini-CEXs, CbDs, ACAT Inadequate = D None = E Educational supervisor’s report Poor = D Very poor = E

ST4 6 Mini-CEXs 6 CbDs 1 MSF 1 ACAT Patient/Carer Survey Acute Audit Educational supervisor’s report Research methods course certificate

ST4 – RITA decision points As for ST3 plus MSF Poor = D None or very poor = E ALS None for 2 years = E Acute Audit None or poor = D

ST5 Knowledge based specialty exam 6 Mini-CEXs 6 CbDs 1 ACAT Educational supervisor’s report 1 Rehab/Discharge Audit Assessed teaching presentation Teaching course certificate

ST5 – RITA decision points As for ST3 plus Knowledge based specialty exam Not passed = D Audit None or very poor = E

ST6 6 Mini-CEXs 6 CbDs 1 Patient/Carer Survey Educational supervisor’s report + PYA 1 Community/Intermediate care Audit Research presentation

PYA Educational supervisors reports satisfactory Curricular objectives met & recorded Time keeping/absences Communication Research & Audit, Teaching & Management Participated in formulating guideline/pathway CPD online registration

ST6 – RITA decision points As for ST3 plus PYA Poor = D, very poor = E KBA Not passed = E MSF Audit No cycle = E Teaching & Research methodology course & presentation & publication Absent = D

ST7 1 Mini-CEX 2 CbDs 1 ACAT Educational supervisor’s report 1 Publication Management course certificate

ST7 – RITA decision points All = E Unsatisfactory Mini-CEX, CbDs, ACAT No Research, Teaching, Management courses Unsatisfactory clinical governance portfolio Very poor supervisor’s report Not met mandatory PYA goals

And now with your CCT…

…you are ready to become a consultant