Scheme for Registration Timeline Supervised Practice 3rd year Introduction to SfR University visit Begin Scheme 1 month Visit 1 3 months Visit 2 6 months Visit 3 7+months Visit 4 8+months Stage 2 Visit 1 year + OSCE 10 Elements of competence 32 Elements of Competence 33 Elements of competence Additional Stage 1 Visit usually required Over-arching elements + FA of Routine and CLs by a different assessor Stage 1 Assessment Stage 2 Assessment Final Assessment So let’s take a closer look at the assessment process.   You will see that at the first assessment we will assess only 10 competencies. This acts as an introduction to the assessment process. This assessment will occur about a month after your trainee begins in practice, and they will have to have seen some patients in that time. What we will ask them to do is perfectly feasible in that time span, however. This assessment will help you and your trainee to understand the process which means your trainee will be ready for the next assessment when considerably more competencies will be assessed. It will also give them an opportunity to revise what they already know and to have a deep understanding that you can apply to the real situations they come across. Some trainees will complete the first stage of the work-based assessment in three visits. But most will need four. The assessor will assess your trainee by watching them undertake certain procedures and by discussing with them cases that they have managed in the past which will be drawn from their logbook. He or she might also question the trainee on conditions related to those cases by using photographs and case scenarios. Remember that they will be questioned around the subject. They should think about the cases they have seen and ask themselves ‘what if this had happened or that had happened’. Remember that with each case they should apply the knowledge and skills they have learned to that particular patient. The assessor will be in touch before each assessment and will ask the trainee to send him or her materials in preparation. The materials should be sent to the assessor the materials in good time (not at one minute to midnight on the day of the deadline). And the patients should also be booked in good time. We know from successful trainees in the past that being well prepared and well organised are key to success. The Stage 2 visit will take place once the trainee has been signed off by your first assessor. In this assessment the trainee will have to undertake a routine examination and a soft contact lens fitting and aftercare on a simulated patient provided by the College. They will also be asked to provide details of a certain number of cases and will have to discuss some of them with the second assessor. The purpose of this Stage 2 visit is to ensure that the trainee is maintaining their competence in all areas and that they are able to integrate and apply their knowledge and skills in real situations. The OSCE which will take place under examination conditions is a double check to ensure they are competent across the board. 1

Important Stage 1 and Stage 2 completion dates for OSCE sittings Deadline for Stage 1 sign off to guarantee a full Stage 2 visit before the OSCE application deadline  Stage 2 completion date for next available round of OSCE’s OSCE dates Friday 19 April 2019 Friday 31 May 2019 Summer 2019 15 – 26 July (inclusive) Friday 21 June 2019 Friday 2 August 2019 Autumn 2019 16 – 27 Sept Check website for details January & March 2020 The Stage 1 assessor will regularly review each trainee’s progress to ensure they are realistic in their expectations of when they will be ready to sit the OSCE

Demonstrating competence Where the element of competence requires that you: “Do” something - the assessor will expect to see you work with patients to perform that particular skill or procedure, either by watching you (DO) or looking at what you have done previously in your patient records (PR). “Understand” something - as a minimum, there will be a “what if” case scenario (CS) discussion with the assessor about that element based on your patient records or a case scenario presented by the assessor. There are other forms of evidence including recognising images of ocular conditions and managing them (I) and prescription interpretation (PI) and knowledge seeking questions (Q). Check that your evidence is valid and relevant to the element descriptor

Demonstrating competence The assessment of evidence by the assessor is an individualised process which is determined by: Firstly, the compulsory direct observation or patient record evidence which the trainee is required to provide. Then follow up questions or case scenarios will provide the opportunity for further evidence so that the requirements of the performance indicators can be met. This means that you will not have the same assessment as another trainee but it will be to the same standard

Demonstrating competence For example: Element of Competence Compulsory evidence Indicators 6.1.8. Evaluates glaucoma risk factors to detect glaucoma and refer accordingly. PR Patient requiring management for potential suspect glaucoma (not solely ocular hypertension) Discusses the key risk factors. Identifies findings suggestive of open and closed angle glaucoma from clinical examination. Uses the above information to determine if referral is appropriate. Decides on urgency and pathway of referral. Record provided refers to a patient with suspect POAG with disc and field changes. If all the salient points were covered then no further clarification is required relating to POAG. The assessor’s case scenario or questioning would simply be around ’closed angle glaucoma’. The opposite would apply if the PR evidence provided by the trainee related to closed angle glaucoma.

How to present your records to the assessor Use the following format to show your assessor how the record provides appropriate evidence for an element of competence: The relevant presenting symptoms and history Your investigations and findings Your clinical decision and management Advice given to your patient

Patient confidentiality and supervision requirements For patient records to be used as evidence: You must seek patient consent for ALL their records to be viewed by one or more College assessors as part of the process (please note this also includes dispensing, CL related and hospital records) Patient consent must noted on the records Verbal consent from the patient is sufficient You must note in your logbook and on the patient record the name of the person supervising you when you dispensed / examined this patient

Contact lens and Dispensing records You must provide complete records in the assessment process (i.e. not just dispensing orders or partially completed CL records) If in doubt then to help with recording evidence, use the College templates found in your handbook as your original record. These must be completed at the time of the patient interaction and signed by your supervisor to confirm Use these templates particularly if you want to use the record as evidence in the assessment process.

Contact Lens Fitting and Aftercare What constitutes an appropriate CL fitting patient record Take all relevant preliminary measurements From these measurements decide on appropriate lens specification Order the lenses or select from stock Check ordered lenses on eye Instruct patient to wear the lenses and review at a follow up appointment to issue contact lens prescription. The fitting is not complete until the prescription is issued It is appropriate to count these follow up visits towards your aftercare totals

Contact Lens Fitting and Aftercare What constitutes an appropriate CL aftercare patient record The patients need to have worn the lenses (be real wearers!) and require a refractive correction It is appropriate to count the 2 week follow up visits towards your aftercare totals You will need to provide a minimum of 20 aftercares records of patients who are established wearers having worn the lenses on a regular basis for a minimum of 6 months If the patients seen for aftercare are all straightforward with few or no complications, is low then the assessor will use images of RGP aftercare complications to investigate your ability in this area along with the observation and the evidence from your patient records

HES Experience For community practice based trainees You must use your HES logbook to provide evidence of your HES experience This should be completed at each of your HES visits by your HES supervisor Finally it should be shown to your practice supervisor for sign off before being used in the assessment process

Acceptable Witness Testimony Evidence this should clearly identify what the trainee has done whilst being observed by the Witness

Fair assessment Reasonable adjustments Complaints and appeals If you feel that you may need special consideration e.g. dyslexia: Write to the Director of Education at the College stating: Your special circumstance What reasonable adjustments you would wish to be made to allow assessments to be equitable with that of other candidates (Scheme for Registration Regulations, College Website ) Complaints and appeals Work-based assessment Complaints process for work based appeal (Scheme for Registration Regulations, College Website )

Fair assessment Quality Assurance in the Scheme The Scheme is quality assured at all stages by strict systems and processes. In the work based assessment all assessors have to participate in compulsory annual training plus their: assessments are observed assessment reports assessed trainees interviewed on a regular basis which is dictated by the experience of the assessor and the number of trainees they assess. In the final assessment OSCE examiners also have to participate in compulsory annual training Their marking decisions are peer reviewed on the day and moderated, if required, by the Final Assessment Panel.

Contacting me Best route for the quickest response Email: Text or leave a message on mobile Next Home number: Finally GPO but not registered or recorded delivery to: Visit Preparation: all relevant information must be sent to me at least 1 week before the assessment date. If it does not arrive neither do I. If your assessment visit is cancelled at short notice then you will be charged for the visit