1. E-portfolio and WPBA

3. Curriculum
Assessment

4. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

5. Case-based Discussion (CbD) 3
WPBA Tool
Minimum Requirements for ST1 per 6months
Case-based Discussion (CbD) 3
Clinical Evaluation Exercise (MiniCEX) for use in hospital posts only
Multi-Source Feedback (MSF)
1 (5 clinicians each)
Direct Observation of Procedural Skills (DOPS)
Progressing to Clinical Examination and procedural skills (CEPS)
Clinical Supervisors Report (CSR) to be undertaken in all hospital posts, but can also be used in the primary care setting 1
Learning Log and Personal Development Plan (PDP)
Aim for 2 LL per week and ongoing PDP items (1 per month)
Placement planning meeting
Significant event analysis
Audit (1 per year)
Educational Supervisors Report (ESR)
Patient Satisfaction Questionnaire (PSQ) for use in primary care only
1 per year
Consultation Observation Tool (COT) for use in primary care only

8. Other things Child protection training level 3
With discussion with trainer and reflective LL
BLS + AED training in GP
Out of hours (GP placements)

9. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

10. Where does WPBA fit in?
Competence
CSA
AKT
WPBA

11. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

12. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

13. Mini-CEX
The Clinical Evaluation Exercise (miniCEX) assesses clinical skills, attitudes and behaviours in a secondary care setting.
The miniCEX provides a 15-minute snapshot of how you interact with patients in a secondary care setting.
Each miniCEX should represent a different clinical problem, and you should have drawn samples from a wide range of problem groups by the end of the speciality training years one and two (ST1 and ST2).
The mini-CEX may be observed by a staff grade doctor, nurse practitioner, clinical nurse specialist, an experienced specialty registrar (ST4 or above) or consultant. The observer should not be a peer - a fellow GP trainee or specialty trainee at a similar stage in training.

14. Mini-CEX form

15. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

16. CBDs Specialty training years one and two (ST1 and ST2)
In ST1 and ST2, you’ll select two cases. You present the clinical entries and relevant records to your clinical supervisor or educational supervisor one week before the discussion. Your clinical or educational supervisor selects one of these cases for discussion.
Balance of cases including:
Children, mental health, cancer and palliative care, older adults

17. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

18. Educational Supervisor
Competency Framework
Learning Log
Curriculum coverage
Trainee

20. Learning Logs What did you learn?
What happened?
What if anything happened susequently?
What did you learn?
What will you do differently in future?
What further learning needs did you identify?
How and when will you address these?

21. E-portfolio - tips Think of it like a notebook or diary
Record both the general and specific
Recording your feelings is good
Enter and SHARE logs as you go along
It’s about quality not quantity

22. An eportfolio learning log entry – not from this area!
What was the subject and aims of the tutorial?
recognising common and uncommon skin problems that may present to general practice. diagnosis, investigation and management of these situations and when to refer
What led to this particular subject being chosen?
find it very interesting
What did you learn?
What will you do differently in future?
What further learning needs did you identify?
How and when will you address these?
Shared? :
Yes
Reflect?
Primary Care?

23. Disagreement with a senior
It hurts
I was only doing my job, the patient was unwell...
We were both trying to help the patient
Lots of health care problems are to do with communication
How can I communicate better?
It hurts
I was only doing my job, the patient was unwell...
I reflected on our professional duties
He was unprofessional
I was professional, I didn’t talk to him about it

24. A different voice

25. Now have a go…
Think of a clinical encounter that has interested you, challenged you, surprised you and write a learning log

26. Learning Logs What did you learn?
What happened?
What if anything happened susequently?
What did you learn?
What will you do differently in future?
What further learning needs did you identify?
How and when will you address these?

27. How did you do?

28. Feedback What went well? What could have been improved?
How did you find the experience?

29. What are the key competencies of workplace based assessment ?

30. Competency Framework
1 Communication and consultation skills 2 Practising holistically 3 Data gathering and interpretation 4 Making a diagnosis/decisions 5 Clinical management 6 Managing medical complexity 7 Organisation, management and leadership 8 Working with colleagues and in teams 9 Community orientation 10 Maintaining performance, learning and teaching 11 Maintaining an ethical approach 12 Fitness to practise 13 Clinical examination and procedural skills
Tip: ask your ES to open a review for the next 6months

33. Curriculum headings 1 Being a General Practitioner
The core curriculum statement provides a full description of the knowledge, skills, attitudes and behaviours required of a GP in managing patients and their problems.
1 Being a General Practitioner [PDF]
 2 Contextual statements    
The four contextual statements explore particular aspects of general practice in greater depth.
2.01 The GP consultation in practice [PDF]
2.02 Patient safety and quality of care [PDF]
2.03 The GP in the wider professional environment [PDF]
2.04 Enhancing professional knowledge [PDF]
Being a General Practitioner

34. Curriculum headings 2 3 Clinical statements
The clinical examples apply the competences in Being a General Practitioner to population groups or to organ based conditions.
3.01 Healthy people: promoting health and preventing disease [PDF]
3.02 Genetics in primary care [PDF]
3.03 Care of acutely ill people [PDF]
3.04 Care of children and young people [PDF]
3.05 Care of older adults [PDF]
3.06 Women’s health [PDF]
3.07 Men’s health [PDF]
3.08 Sexual health [PDF]
3.09 End of life care [PDF]
3.10 Care of people with mental health problems [PDF]
3.11 Care of people with intellectual disability [PDF]
3.12 Cardiovascular health [PDF]
3.13 Digestive health [PDF]
3.14 Care of people who misuse drugs and alcohol [PDF]
3.15 Care of people with ENT oral and facial problems [PDF]
3.16 Care of people with eye problems [PDF]
3.17 Care of people with metabolic problems [PDF]
3.18 Care of people with neurological problems [PDF]
3.19 Respiratory health [PDF]
3.20 Care of people with musculoskeletal problems [PDF]
3.21 Care of people with skin problems [PDF]

35. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

36. PDP Now have a go Prospective SMART 1 per month? Specific Measurable
Achievable
Realistic
Time bound
1 per month?
Now have a go

37. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

38. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

39. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

40. DOPS  CEPS Clinical Examination and Procedural Skills
This competence is about clinical examination and procedural skills and by the end of training, the trainee must have demonstrated competence in Breast examination and in the full range of male and female genital examination
Insufficient Evidence
Needs Further Development
Competent
Excellent
From the available evidence, the doctor’s performance cannot be placed on a higher point of this developmental scale
Chooses examinations broadly in line with the patient’s problem(s)
Chooses examinations appropriately targeted to the patient’s problem(s)
Proficiently identifies and performs the scope of examination necessary to investigate the patient’s problem(s)
Identifies abnormal signs but fails to recognise their significance
Has a systematic approach to clinical examination and able to interpret physical signs accurately
Uses an incremental approach to examination, basing further examinations on what is known already and is later discovered
Suggests appropriate procedures related to the patient’s problem(s)
Varies options of procedures according to circumstances and the preferences of the patient
Demonstrates a wide range of procedural skills to a high standard
Demonstrates limited fine motor skills when carrying out simple procedures
Refers on appropriately when a procedure is outside their level of skill
Actively promotes safe practice with regard to examination and procedural skills
Observes the professional codes of practice including the use of chaperones
Identifies and discusses ethical issues with regard to examination and procedural skills
Engages with audit quality improvement initiatives with regard to examination and procedural skills
Performs procedures and examinations with the patient’s consent and with a clinically justifiable reason to do so
Shows awareness of the medico-legal background to informed consent, mental capacity and the best interests of the patient
Helps to develop systems that reduce risk in clinical examination and procedural skills
The intimate examination is conducted in a way that does not allow a full assessment by inspection or palpation. The doctor proceeds without due attention to the patient’s perspective and feelings
Ensures that the patient understands the purpose of an intimate examination, describes what will happen and explains the role of the chaperone. Arranges the place of examination to give the patient privacy and to respect their dignity.
Inspection and palpation is appropriate and clinically effective.
Recognises the verbal and non-verbal clues that the patient is not comfortable with an intrusion into their personal space especially the prospect or conduct of intimate examinations. Is able to help the patient to accept and feel safe during the examination.

41. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

42. Clinical Supervisor’s Report (CSR)
Diagnostics
Relationship
Management
Professionalism

43. A GP placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
COT consultation observation tool
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback (ST3)
PSQ patient satisfaction questionnaire
SEA significant event analysis
CEPS clinical examination and procedural skills
OOH Out of hours experience
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

44. COT form

45. OOH 36 hours in ST2 during GP placement
Can do extra in ST2 but only 12hrs extra can be carried forward to ST3
108 hours total including induction
Upload all signed forms to an OOH learning log with documented hours on form
Keep running total
Eg OOH session 6hours 48hours total
BOOK INDUCTION VERY EARLY

46. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
ESR Educational supervisors report
ARCP

47. Six-monthly review
You meet your educational supervisor every six months to review the evidence you’ve collected against the 13 areas of professional competence.
You’ll need to complete a self-assessment prior to the meeting.
December and end of May
4-8weeks before ARCP

48. ESR - Trainee Self-Rating
You are able to access a summary table of all evidence during that review period which relates to each competence.
You can view each piece of evidence and select a maximum of 3 entries per competence heading.  
These can be learning logs, CbDs, COTs, etc – each will be labelled by date, subject title, etc for easy identification.
Chosen evidence will then appear as linked items within the self-rating.
You will still be required to write a summary in the evidence box explaining their reasoning.
You write suggested action plans for next 6 months.

50. The goals of training are....
.....to complete a JEST survey!
Joke!
But don’t forget it or your revalidation (R) form

51. A hospital placement sandwich
WPBA as part of MRCGP
Placement Planning Meetings
Mini-CEX clinical evaluation exercise
CBDs case based discussion
Learning Logs
Competency framework
Curriculum coverage
PDP personal development plan
MSF multi-source feedback
SEA significant event analysis
CEPS clinical examination and procedural skills
CSR Clinical supervisor’s report
Educational supervisors report
ARCP

52. ARCP
CBDs etc
ESR
CSR
LLEs PDPs

53. ARCP

54. ARCP
Turning up to a panel is not “optional”, it is part of your educational contract. Service commitments do not take preference. You will know when your panel is, be prepared!

55. ARCP
CBDs etc
ESR
CSR
LLEs PDPs

56. What’s it for? An educational tool for you to develop
A record of evidence of your training