Orthopaedic Competence Assessment Project The Orthopaedic Competence Assessment Project is a joint endeavour of the BOA, JCHST, University of Dundee It is a practically-oriented project attempting to introduce workplace assessment into the HST Orthopaedic training programme Using the tools David Pitts d.pitts@rcsed.ac.uk

OCAP – Mission Improve the quality of HST in orthopaedics through the introduction of a competence based portfolio of coaching and assessment tools

This Presentation Overview of system & tools Trainer profile Learning Agreement Procedure Based Assessments Records Coaching

Coaching, Assessment & Recording Tools Overview Coaching, Assessment & Recording Tools Knowledge Assessment Curriculum Vitae Trainer Profile Learning Agreement Evidence Procedures Coaching

Features Knowledge Curriculum Vitae Trainer Profile Procedures

Features Knowledge Curriculum Vitae Trainer Profile Procedures

Features Trainer Profile Learning Agreement Knowledge Assessment Curriculum Vitae Procedures Knowledge Coaching Assessment Evidence

Overview Trainer Profile Learning Agreement Knowledge Assessment Curriculum Vitae Procedures Knowledge Coaching Assessment Evidence

Coaching, Assessment & Recording Tools Overview Coaching, Assessment & Recording Tools Knowledge Assessment Curriculum Vitae Trainer Profile Learning Agreement Evidence Procedures Coaching

Entire process driven by trainee Meeting 3 Completed PBA’s Consolidation Sheet PBA Meeting 2 Only 3 pieces of paperwork All will become electronic in time PBA Meeting 1 Entire process driven by trainee Learning Agreement Trainer Profile

Developing a Trainer Profile Knowledge Curriculum Vitae Trainer Profile Procedures

One time only! In What I do collaboration (Procedures) with Trainee What you need to know about what I do (Knowledge) Supported by Templates One time only! What you need to know about me (CV)

Trainer Profile 1: Procedures Tools in detail Trainer Profile 1: Procedures Procedures map Based on e-logbook Template on CDROM Add your name Delete inapplicable Add whatever’s missing Comprehensive? Willing to teach? Save as new file Trainer profile has three elements that will set expectations for the trainee

Trainer Profile 2: Knowledge Tools in detail Trainer Profile 2: Knowledge Knowledge map BOA syllabus Template on CDROM Add your name Delete inapplicable Delete rows, backspace! Add anything missing Develop over time! Trainer profile has three elements that will set expectations for the trainee

Trainer Profile 3: Mini-CV Tools in detail Trainer Profile 3: Mini-CV CV (brief) Build relationship Communicate expectations of Trainee’s performance, behaviour, attitude… Samples on CDROM Add your name Add photograph Cut & paste Save as new file Trainer profile has three elements that will set expectations for the trainee

Using a Trainer Profile Knowledge Curriculum Vitae Trainer Profile Procedures

1. Using the CV Build relationship Communicate expectations Performance Behaviour / conduct Attitude… “Being a surgeon is more than doing surgery” Trainer profile has three elements that will set expectations for the trainee

2. Using the Procedures profile 1st year trainee 4th year trainee The trainee brings this to the meeting or sends it beforehand Trainer selects what is appropriate from his/her practice in discussion with trainee and in light of trainee’s previous experience This form can be referred to in any session and progress mapped on it

3. Using the Knowledge profile 1 = Knows of 2 = Knows basic concepts 3 = Knows generally 4 = Knows specifically & broadly BOA syllabus Not the exam! To help trainee make progress Guide reading/study

This Presentation Overview of system & tools Trainer profile Learning Agreement Procedure Based Assessments Records Coaching

End of attachment summary Meeting 3 Learning Agreement PBA End of attachment summary Meeting 2 PBA Progress Review Meeting 1 Agenda Setting Each meeting 20 minutes?

Meeting 1 Review materials completed by trainee beforehand Tick boxes Sign form Length/depth of discussion & how much you write is up to you

Meeting 2 Provide feedback to trainee Review feedback already given in theatre or assessments Tick boxes Agree actions Sign form

Meeting 3 Trainee completes reflection beforehand (detail up to you) Trainer & trainee agree progress Tick boxes Sign form

This Presentation Overview of system & tools Trainer profile Learning Agreement Procedure Based Assessments Records Coaching

Results entered onto PBA summary sheet Meeting 3 Individual sheets signed and kept in portfolio Meeting 2 PBA Triggered by Trainee or trainer Meeting 1 Agree which ones (all or part) at first meeting

Current PBAs (01 03 05) Tools in detail Mini-PBA (DOPS) Hand Knee Foot Closed mgt of # Clinic activity in T&O Debridement of wound Hand Carpal tunnel decompression Digital and palmar fasciectomy Knee Diagnostic arthroscopy & simple arthroscopic procedures Total knee replacement Foot 1st ray surgery Hip Total hip replacement Spine Lumbar discectomy Generic template Trauma Compression hip screw intertrochanteric fracture neck of femur Hemiarthroplasty intra capsular fracture neck of femur Application of limb external fixator Operative fixation Weber B ankle fracture Fixation by tension band wiring, olecranon & patella Intramedullary nailing femoral or tibial shaft Tendon repair In development Upper limb Paediatric

Performance Based Assessments Tools in detail Performance Based Assessments Triggered Trainee or trainer Objective Passed / To be improved Indicative Formative individually Summative as whole collection Common format Consent Preoperative planning Preoperative preparation Exposure & closure Intra operative technique Post operative mgt During an attachment the trainee will complete several PBA’s There may eventually be many PBA’s but only a small subset will be validated Theoretically any procedure may be set out in PBA format PBA’s cover a variety of skills, primarily they demonstrate the ability to learn, they are not intended as a “you are now qualified to do this procedure” document. It is hoped to have 20 key PBA’s that will be indicative of the whole range of orthopaedic practice. Users Guide on website

Example: THR Trainee has forms beforehand (no surprises) Trainer agrees to the PBA (patient, trainee etc) Trainee conducts procedure observed by trainer Usually scrubbed Trainee verbalises, explains what intentions are Trainer steps in as/where necessary Forms completed and feedback given immediately after procedure

This Presentation Overview of system & tools Trainer profile Learning Agreement Procedure Based Assessments Records Coaching

Learning Agreement

PBA Consolidation sheet Tools in detail PBA Consolidation sheet For discussion at RITA Must be presented on request Compares scores across PBA’s Evidence of “Learning” Trainee updates as attachment progresses Brings to meeting 2 & 3

Final summary: PBA Consolidation sheet (2 sides)

Portfolio Checklist Weekly timetable for attachment SAC Details of on call rota Trainer CV (from trainer portfolio) Procedures Profile (original, signed) Knowledge Profile (original, signed) Learning Agreement agendas (original, signed) All individual assessments completed (original, signed) In-house educational programme (with note of sessions attended) Evidence of activity on audit/research project Details of significant events (to include clinical and professional incidents (and outcomes)) Details of absences from training post

This Presentation Overview of system & tools Trainer profile Learning Agreement Procedure Based Assessments Records Coaching

Personal Effectiveness Mindmap Viewer software free via website Positive & negative behaviours Facilitates feedback

This Presentation Overview of system & tools Trainer profile Learning Agreement Procedure Based Assessments Records Coaching

Overview Trainer Profile Learning Agreement Knowledge Assessment Curriculum Vitae Procedures Knowledge Coaching Assessment Evidence