MMC – workplace based assessments Dr Lisa Joels Postgraduate Organiser Singleton Hospital 6 th August 08

Postgraduate Medical Training Move to competency based training Curriculum defines –Competencies –Knowledge –Skills –Attitudes Assessment is key to progression (or not) Assessments will be fair and consistent

The trainee’s responsibilities At appointment –Educational agreement with the Postgraduate Deanery GMC Good Medical Practice Work effectively as an employee E&D, Human Rights Contact with TPD/FPD Learning Portfolio Appraisal Assessments – specialty specific

Competency based training Educational agreement Learning objectives Demonstrate competencies: Assessments, Portfolio Audits, papers, log books Multisource feedback Appraisal Annual Review of Competence Progression Outcome

Educational supervisor Agrees learning objectives Formative (mid point) assessments Reviews evidence Submits report to ARCP panel Agrees action plan according to outcome of ARCP Clinical supervisor VS Educational supervisor

ARCP panel Trainee may not be called to attend (therefore can’t explain gaps) If it isn’t written down, it didn’t happen Outcomes –1. Satisfactory –2. Development needed (no extra time) –3. Inadequate progress (extra time) –4. Released from training programme –5. Incomplete evidence (report in 5 days) –6. Completed training Ref The Gold Guide

Competencies Foundation programme –Foundation curriculum Specialty training –Royal College curricula –Targets for each year of training

Assessments Mini clinical evaluation exercise Case based discussions Direct observation of procedural skills Multisource feedback Observed video assessments Observations in clinical skills facilities Essential courses Drills

Mini CEX Assesses: –History taking –Physical examination –Professionalism –Clinical judgement –Communication skills –Organisation/efficiency –Overall clinical care

CbD’s One aspect of a case Assesses: –Medical record keeping –Clinical assessment –Investigation and referrals –Treatment –Follow up and future planning –Professionalism –Overall clinical judgement

DOPS A procedure from day-today practice Assesses: –Understanding e.g. anatomy/indications –Informed consent –Analgesia/sedation –Technical ability –Aseptic technique –Asks for help –Post procedure management –Communication skills –Professionalism –Overall ability

Multisource feedback 360 degree appraisal –Multiple assessors (usually >10) –Nurses, AHP’s, clerical staff –Peers & senior staff Patient survey

Portfolio Electronic or paper Collates evidence needed to prove competence & progress What to keep in portfolio –Reflective notes –Log books (n.b. confidentiality) –Attendance certificates, qualifications –Copies of audits & publications –Compliments (& complaints)

CCT or CESR Foundation competencies Only route to CCT is via prospectively approved training posts –N.B. if joining at ST2, 3 or 4 need evidence Certificate confirming Eligibility for Specialist Registration (Article 14) CEGPR (article 11)

Wales Deanery All StR’s will have University of Cardiff e mail account All documentation will be e mailed

Problems If trainee hasn’t done required assessments will need to justify in writing to ARCP panel If trainee fails to meet competencies won’t move to next level It is possible to fail – now the Gold Guide only allows 12 months re-training (aggregated)

Summary Learning objectives are now more explicit Multiple assessment tools to demonstrate competence and progression The new system has teeth! If you need help –Educational Supervisor –Training Programme Director –Postgraduate Deanery via PGO

Resources Gold Guide – – Foundation Curriculum – Wales Deanery –