1. Indicators of Potential Underperformance 2014

2. Today What is an IPU? How can we use them? Does the RDMP model help? Educational prescriptions.

3. Reminder RCGP Curriculum Statement: 1. Core Statement: Being a GP

4. Being a GP: 12 Competencies Communication and consultation skills Practising holistically Data gathering and interpretation Making a diagnosis and making decisions Clinical management Managing medical complexity Primary care administration and IMT Community orientation Maintaining performance, learning and teaching Maintaining an ethical approach to practice Fitness to practise

5. 12 competencies: demonstrable behaviour

6. Eportfolio Word pictures: positive descriptors NFD, Competent and Excellent On CBD or ESR

7. Indicators of Potential Underperformance Aim to identify early TID Then offer targeted feedback and remediation

8. IPU “These go beyond the opposites and add useful meaning or emphasis to the themes that they are placed alongside”. Not a level below NFD eg may alter excellent to competent

9. IPU Added to word pictures on E-portfolio…

10. So if IPU noted – what to do? Discuss with trainee Offer feedback and suggestions

11. So if IPU noted – what to do? Is it significant: Recurrent? Noticed by others? Apparent in other situations/areas?

12. A unifying theory of clinical practice: Relationship, Diagnostics, Management and professionalism (RDM-p). Norfolk T, Siriwardena AN. Qual Prim Care. 2009;17(1):37-47

13. RDM-p (2009) Links 12 competencies into 4 clusters Creates links between the competencies to help us understand the relationship between them Can be used diagnostically ….

14. RDMP (2009) http://www.wpba4gps.co.uk/fileadmin/user_ upload/secure/mindmaps/Understanding_the _Theory/Competence_Framework/RDMp_Ma ster/RDMp_Master-V2.pdf

15. What are the reasons for underperformance This may be beyond today but remember include Poor training for general practice; Lack of continuing education; Isolation from colleagues; Physical health problems; Mental health problems including alcohol and drug abuse; Stress related to work or domestic situations; Low morale; Excessive workload; Poor practice infrastructure; Poor relationships within a practice; Poor premises and facilities; and Poor communication and relationship with Educational Leaders.

16. Educational prescription? Do not ignore IPU Establish if significant Be aware of reasons for underperformance Consider how our feedback and educational planning are affected by the IPU