Tackling the Wicked Issues Portfolio Assessment The Fellowship in Advanced Rural General Practice Dr Kathryn Kirkpatrick, Chair NRF

Background The Fellowship of the Royal Australian College of General Practitioners (FRACGP) certifies competence to deliver unsupervised general practice services in any general practice setting in Australia; urban, regional, rural, remote or very remote. It also offers international recognition.

General Practice in Australia occurs in different contexts Metropolitan, Regional Rural and Remote

Background The Fellowship in Advanced Rural General Practice (FARGP) recognises advanced knowledge and skills and the additional training that GPs may undertake to better serve the unique needs of rural and remote communities in Australia. The FARGP grew out of the Graduate Diploma in Rural General Practice and has been the centrepiece of the RACGP’s rural education programs for more than 15 years 421 graduates and 546 current enrolments

FARGP Requirements The development of a learning plan At least 12 months in rural general practice 12 months in an advanced rural skills training post 2 core modules –Working in Rural General Practice –Emergency Medicine 160 hours of self-selected educational activities Regular contact with a medical educator or mentor Submission of portfolio

Fargo. The FARGP mascot

ARST Anaesthetics Obstetrics Surgery Aboriginal Health Mental Health Paediatrics Emergency Medicine Adult Internal Medicine Small Town Rural General Practice Individually designed program (approved by NRF) eg palliative care

The Review In late June and early July 2011 a review of the FARGP was conducted by a consultant and a number of recommendations were made All recommendations were accepted by the Rural Education Committee on 27 th July 2011 The main recommendations involved streamlining the administration, updating learning materials and assessment processes and conducting regular reviews and evaluations

Review of portfolio The paper based portfolio has been problematic Wedded to the process from historical background Lack of consistency of presentation of portfolio Difficult to assess the degree of learning/engagement Variable quality of documentation Difficulty assessing and comparing portfolios (Censor) Loss of portfolio in recent weather events - cyclone and floods GPs don't like doing it

Excellence in education Moving towards more contemporary educational methodology (communities of practice, problem-based learning, reflective practice) Measurable criteria in the development of learning objectives and assessment Encouraging peer support/learning opportunities Moving to an online environment

Rural Censor

Portfolio learning “The evidence base is extensive, but contains few high quality studies with generalisable messages about the effectiveness of portfolios.” 1 “……..good evidence that if well implemented, portfolios are effective and practical in a number of ways including increasing personal responsibility for learning and supporting professional development.” 1 1 Tochel, C: Haig, A: Hesketh, A; Cadzow, AA: Beggs, K: Colthart, A and Peacock, H The effectiveness of portfolios for post-graduate assessment and education: BEME Guide No 12. Medical Teacher, 2009, 31:

The Portfolio What makes a portfolio work well? Robust integration into the curriculum Tutor/mentor/supervisor support Positive trainee attitudes Portfolio assessment using a 30 minute structured interview Careful introduction of portfolios and training of all supervisors Perceived educational benefit Hrisos, S: Illing, J C and Burford, B C Portfolio learning for foundation doctors: early feedback on its use in the clinical workplace. Medical Education 2008, 42: 214 – 223 Burch, V C and Seggie, J L Use of a structured interview to assess portfolio-based learning. Medical Education 2008: 42: 894 – 900 Person, D J and Haywood, P 2004 Portfolio use in general practice vocational training: a survey of GP registrars. Medical Education, 2004: 38: Tochel, C: Haig, A: Hesketh, A; Cadzow, AA: Beggs, K: Colthart, A and Peacock, H The effectiveness of portfolios for post- graduate assessment and education: BEME Guide No 12. Medical Teacher, 2009, 31:

What Now? Continued consultation with the Rural Education Committee, Regional Training Providers, candidates, colleagues and other key stakeholders Slow and steady progress towards a qualification that is contemporary, current, relevant, and engaging. By the end of 2011 (with integration into the new RACGP on-line learning platform) electronic modules and portfolio.

Contact Details Rural education team Vanessa Lynne - Team Leader (Vic) Pauline Curtis – Program Coordinator, Rural and Remote Procedural Grants Program (SA) Jadranka Sosa – R&R PGP Administrator (SA) Dena Livaditis - Rural Education Services Administration Officer (SA) Amy Cooper – Rural Education Administrator (Vic) Phone