1. Competency Based Fellowship Program (CBFP) The Observed Clinical Activity OCA

2. Competency Based Fellowship Program (CBFP) Very similar to the Observed Clinical Interview (OCI) in general structure Formative, not summative assessment

3. Competency Based Fellowship Program (CBFP) Protocol The trainee : Plans in consultation with the assessor to carry out the OCA Nominates a suitable clinical case, ideally new to the trainee Is responsible for all organisation plus consent

4. Competency Based Fellowship Program (CBFP) Protocol – Session 1 The OCA will be split into two sessions Session 1 The interview will run for up to 50 minutes, with a 10 minute feedback session Followed by self reflection in own time

5. Competency Based Fellowship Program (CBFP) Protocol : Session 2 Present the Case (up to 20 minutes) Summary of the salient features of the case An assessment of gaps in the history plus other essential information required A formulation, diagnosis and differential diagnosis, Present a detailed management plan (up to 20 minutes)

6. Competency Based Fellowship Program (CBFP), Protocol : session 2 Feedback – 10 minutes) Once the discussion is complete the assessor provides detailed feedback Ample time for feedback is to be allowed Feedback is to be restricted to the OCA The trainee is responsible for retaining the OCA form within their portfolio

7. Competency Based Fellowship Program (CBFP) Feedback What aspects were done well? Suggestions for areas of improvement Agreed action/goals Learning plan

8. Competency Based Fellowship Program (CBFP) Assessment headings History taking Mental state examination Creating a therapeutic relationship Clinical judgment/Formulation Organisation/Efficiency Physical Examination skills Overall clinical care

9. Competency Based Fellowship Program (CBFP) Rating 1-3 Below standard for stage 4-6 Meets the standard for stage 7-9 Above the standard for the stage

10. Competency Based Fellowship Program (CBFP) Stage 1 Change in functioning Assessment and management of high prevalence disorder Assessment and management of low prevalence disorder

11. Competency Based Fellowship Program (CBFP) Stage 2 Assessment and management of patient with co-morbidity AOP OCA’s

12. Competency Based Fellowship Program (CBFP) Should the OCI like OCA be used unmodified for Stage 1? Time Lots of data, complex message Requires sustained attention, may need more than one day Some registrars just beginning training may be unfamiliar with the format Are some aspects too advanced for Stage 1 developmental milestones?