n mrcgp workplace-based assessment
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n MRCGP Workplace-based Assessment. March 2007. nMRCGP. Integrated assessment package comprising: Applied knowledge test (AKT) Clinical skills assessment (CSA) Workplace-based assessment (WPBA). Workplace-based assessment. - PowerPoint PPT PresentationTRANSCRIPT
Promoting Excellence in Family Medicine
nMRCGPWorkplace-based Assessment
March 2007
Promoting Excellence in
Family Medicine
nMRCGP
Integrated assessment package comprising:
Applied knowledge test (AKT)
Clinical skills assessment (CSA)
Workplace-based assessment (WPBA)
Promoting Excellence in
Family Medicine
Workplace-based assessment
“The evaluation of a doctor’s progress over time in their performance in those areas of professional practice best tested in the workplace.”
Promoting Excellence in
Family Medicine
Some principles of assessment
Validity
Reliability
Educational impact
Acceptability
Feasibility
Promoting Excellence in
Family Medicine
Why workplace-based assessment?
Tests something important and different from other components
“Does do versus can do”
Reconnects assessment with learning
Has high educational impact
Valid and reliable
In keeping with PMETB guidance
Promoting Excellence in
Family Medicine
The WPBA framework
An integrated package comprising a competency-based training record that applies over an entire training envelope (3 years from August 2007)
Promoting Excellence in
Family Medicine
The educational model of WPBA for nMRCGP
Promoting Excellence in
Family Medicine
The competency-based training record
Competency-based
Developmental
Evidential
Locally assessed
Triangulated
Promoting Excellence in
Family Medicine
Competency-based
12 competency areas
Best tested in the workplace setting
Developmental progression for each competency area
Competency demonstrated “when ready”
Process is learner led
Promoting Excellence in
Family Medicine
The 12 competency areas
1. Communication and consulting skills2. Practising holistically3. Data gathering and interpretation4. Making a diagnosis/ making decisions5. Clinical management6. Managing complexity and promoting health
7. Primary care administration and IMT 8. Working with colleagues and in teams9. Community orientation10. Maintaining performance, learning and teaching11. Maintaining an ethical approach to practice12.Fitness to practice
Promoting Excellence in
Family Medicine
Developmental progression
“a process of monitoring a student’s
progress through an area of learning
so that decisions can be made about
the best way to facilitate future learning”
Promoting Excellence in
Family Medicine
Evidential
Notion of multiple sampling
From multiple perspectives
Tool-box of “approved” methods (locally assessed and national complementary tools)
Sufficiency of evidence defined
Promoting Excellence in
Family Medicine
Locally assessed
Assessed by clinical supervisor in hospital or general practice setting
Regular reviews at 6 month intervals by trainer/educational supervisor
Review all the assessment information gathered
Judge progress against competency areas
Provide developmental feedback
Promoting Excellence in
Family Medicine
Triangulated
Different raters
Many tools (e.g. CBD, COT, mini CEX, DOPS, MSF and PSQ)
Different settings (hospital and general practice)
Promoting Excellence in Family Medicine
Gathering the evidence about the learner’s
developmental progress
Promoting Excellence in
Family Medicine
Evidence from
Locally assessed tools
Complementary tools and…
Naturally occurring information
Promoting Excellence in
Family Medicine
Tools for Evidence
CBD (case based discussion)
COT (consultation observation tool)
mini-CEX (clinical evaluation exercise)
DOPS (direct observation of procedural skills)
MSF (multi-source feedback)
PSQ (patient satisfaction questionnaire)
Promoting Excellence in
Family Medicine
Case-based discussion
Structured oral interview
Designed to assess professional judgement
Across a range of competency areas
Starting point is the written record of cases selected by the trainee
Will be used in general practice and hospital settings
Promoting Excellence in
Family Medicine
COT
Tool to assess consultation skills
Based on MRCGP consulting skills criteria
Can be assessed using video or direct observation during general practice settings
Promoting Excellence in
Family Medicine
Mini CEX
Used instead of COT in hospital settings
Promoting Excellence in
Family Medicine
DOPS
For assessing relevant technical skills during GP training:
Cervical cytology
Complex or intimate examinations (e.g. rectal, pelvic, breast)
Minor surgical skills
Similar to F2 DOPS
Promoting Excellence in
Family Medicine
MSF
Assessment of clinical ability and professional behaviour
ST1 Rated by 5 clinical colleagues, 2 occasions ST3 Rated by 5 clinical and 5 non-clinical colleagues on 2 occasions
Simple web based tool
Is able to discriminate between doctors
Needs skill of trainer in giving feedback
Promoting Excellence in
Family Medicine
PSQ
Measures consultation and relational empathy (CARE)
30 consecutive consultations in GP setting
Central optical scanning and generation of results
Can differentiate between doctors
Needs skill of trainer in giving feedback
Promoting Excellence in
Family Medicine
Naturally occurring evidence
From direct observation during training
“tagged” against appropriate competency headings
Other practice-based activities
Promoting Excellence in
Family Medicine
Monitoring Progress
Interim reviews with trainer
6 month intervals
ensure the trainee is making satisfactory progress
agree training needs
Promoting Excellence in
Family Medicine
Monitoring Progress
Deanery Panel meeting at end of ST1 and ST2 reviews the training records of every trainee face to face review with trainees when
unsatisfactory achievement in either of the complementary tools or when requested by the educational supervisor
Promoting Excellence in
Family Medicine
Workplace-based assessment ST1
Interim review
Based on evidence:
3 x COT or mini-CEX
3 x CBD
1 x MSF
1 x PSQ *
DOPS **
Clinical supervisors’ report **
Interim review
Based on evidence:
3 x COT or mini-CEX
3 x CBD
1 x MSF
1 x PSQ *
DOPS **
Clinical supervisors’ report **
6 month 12 month Deanery panel if unsatisfactory
* if GP post
** if appropriate
Promoting Excellence in
Family Medicine
Workplace-based assessment ST2
Interim review
Based on evidence:
3 x COT or mini-CEX
3 x CBD
1 x PSQ *
DOPS **
Clinical supervisors’ report **
Interim review
Based on evidence:
3 x COT or mini-CEX
3 x CBD
1 x PSQ *
DOPS **
Clinical supervisors’ report **
18 month 24 month Deanery panel if unsatisfactory
* if GP post
** if appropriate
Promoting Excellence in
Family Medicine
Workplace-based assessment ST3
Interim review
Based on evidence:
6 x COT
6 x CBD
1 x MSF
DOPS **
Final review
Based on evidence:
6 x COT
6 x CBD
1 x MSF
DOPS **
PSQ
30 month 34 monthDeanery sign off or panel review if unsatisfactory
** if appropriate
Promoting Excellence in
Family Medicine
The final judgement
The trainer makes a recommendation as to whether the trainee has achieved competence in all 12 areas at the end of training
Promoting Excellence in
Family Medicine
Review by Deanery Panel
Review of e-portfolio if satisfactory level achieved in training record
Review of e-portfolio and face-to-face meeting with trainee, if satisfactory level not achieved