1 / 32

nMRCGP and WPBA Dr. Jon Chadwick , Scarborough VTS 2007

new Membership of the Royal College of General Practitioners Work Place Based Assessment. nMRCGP and WPBA Dr. Jon Chadwick , Scarborough VTS 2007. Some key principles. 36 month process (for GP specialist trainees starting Aug 07) Trainee led Trainees use ePortfolio to amass evidence

toby
Télécharger la présentation

nMRCGP and WPBA Dr. Jon Chadwick , Scarborough VTS 2007

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. new Membership of the Royal College of General Practitioners Work Place Based Assessment nMRCGP and WPBADr. Jon Chadwick, Scarborough VTS 2007

  2. Some key principles • 36 month process (for GP specialist trainees starting Aug 07) • Trainee led • Trainees use ePortfolio to amass evidence • many tools to provide evidence of competence, depending on context • aim to demonstrate competence in number of domains by end of WPBA • The standard by which you should assess, throughout WPBA, is “fit for independent practice in UK NHS general practice” • Tools have a rating scale ‘needs further development’, ‘competent’, ‘excellent’ (+ ‘insufficient evidence’ = not assessed) • Important note: the step before ‘competent’ is not ‘incompetent’ - trainees at the beginning of WPBA are expected to have professional developmental needs nMRCGP & WPBA introduction for clinical supervisors

  3. More key principles • The RCGP website provide the latest information and guidance • http://www.rcgp.org.uk/ • It is being continually updated. • Whilst the process is Trainee led, this will be supported by an educational supervisor • There are 3 monthly reviews throughout training at which progress will be reviewed and actions agreed nMRCGP & WPBA introduction for clinical supervisors

  4. The GP curriculum http://www.rcgp-curriculum.org.uk/ http://www.rcgp-curriculum.org.uk/extras/curriculum/index.aspx • The curriculum covers the knowledge and skills that all GP StRs need to learn in order to deliver the highest quality standards of patient care nMRCGP & WPBA introduction for clinical supervisors

  5. Work Place Based Assessment • The WPBA is designed to assess what trainees actually do • 12 competences • Best tested in the workplace setting • Developmental progression for each competency area • Competency demonstrated “when ready” • Process is learner led • Triangulated • Different raters • Many tools (e.g. CBD, COT, CEX, DOPS, MSF and PSQ) • Different settings (general practice and secondary care) nMRCGP & WPBA introduction for clinical supervisors

  6. The 12 competency areas • Communication and consulting skills • Practising holistically • Data gathering and interpretation • Making a diagnosis/ making decisions • Clinical management • Managing complexity and promoting health • Primary care administration and IMT • Working with colleagues and in teams • Community orientation • Maintaining performance, learning and teaching • Maintaining an ethical approach to practice • Fitness to practise nMRCGP & WPBA introduction for clinical supervisors

  7. Assessment tools • CbD Case based discussion • COT Consultation observation tool (GP only) • DOPS Directly observed procedures • CEX Clinical evaluation exercise • MSF Multi-source feedback • NOE Naturally occurring evidence • PSQ Patient satisfaction questionnaire (GP only) • CSR Clinical supervisor’s report • Some tools will be familiar from FY1 & 2, but may be applied differently for GP training • The different tools test different competency areas • Not every tool is used in every setting (ie primary vs secondary care) nMRCGP & WPBA introduction for clinical supervisors

  8. Different tools allow different competences to be demonstrated nMRCGP & WPBA introduction for clinical supervisors

  9. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  10. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  11. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  12. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  13. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  14. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  15. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  16. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  17. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  18. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  19. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  20. There are detailed descriptors for the different competency levels nMRCGP & WPBA introduction for clinical supervisors

  21. WBA tools in hospital posts Supervisor and trainer (or other member of team) Trainee via ePortfolio Multi-source feedback Naturally Occurring Evidence Patient Satisfaction Questionnaire • Case based discussion • mini-CEX is instead of COT in secondary care • Directly Observed Procedures • Naturally Occurring Evidence • Clinical Supervisors Report nMRCGP & WPBA introduction for clinical supervisors

  22. Assessments in practice • Trainee led • Well planned with adequate notice to supervisor • Preparation by both parties is strongly advised • Case selection is very important to allow demonstration of different competences. All need to be covered to complete WPBA • Each assessment is followed by feedback and completion of the forms in the ePortfolio nMRCGP & WPBA introduction for clinical supervisors

  23. Assessments in practice • The college website details the minimum evidence required for each post http://www.rcgp.org.uk/the_gp_journey/nmrcgp/wpba_and_eportfolio/minimum_evidence.aspx • More assessments may be done if required • Minima prior to 6 month review (ST1 ST2):- • 3 x CEX (COT in GP) • 3 x CbD • 1 x MSF, 5 clinicians only • DOPS • Clinical supervisor’s report nMRCGP & WPBA introduction for clinical supervisors

  24. Case Based Discussion(CbD) • Allows demonstration of competence in 10 of the 12 competency areas • An overall balance of cases is required. • In ST1 and ST2 - a minimum of 3 CbDs in each 6 month post (whether hospital or GP) • One week prior to the discussion two cases should be selected and presented with relevant records to the assessor • The assessor will choose one of the cases for discussion nMRCGP & WPBA introduction for clinical supervisors

  25. Case Based Discussion (CbD) • It is essential that the assessor is given the cases a week in advance to allow for proper preparation of questions • Although not essential, trainees can facilitate a good outcome by, in addition to submitting the relevant clinical records, also • providing a commentary of why the case was chosen • and indicate which competences are demonstrated • Case selection is important • It is difficult to demonstrate excellence if the level of challenge is low nMRCGP & WPBA introduction for clinical supervisors

  26. The CbD Interview • 20 minutes discussion per case • The assessor should use pre-prepared questions designed to allow demonstration of competence. • These questions will focus on things such as what you did and why you did it • One CbD interview is likely to allow approximately three competences to be discussed (the others will be graded “insufficient evidence”) • 10 minutes for feedback and completion of the assessment form (which will be uploaded to your ePortfolio) • The assessment form includes sections for feedback and recommendations for further development and agreed action nMRCGP & WPBA introduction for clinical supervisors

  27. Clinical Evaluation Exercise (CEX) • Mini-CEX is a 15 minute snapshot of doctor/patient interaction, within a secondary care setting • It is designed to assess the clinical skills, attitudes and behaviours of trainees essential to providing high quality care • Trainees will be asked to undertake three observed encounters during 6 months, with a different observer for each encounter • Each of these encounters should represent a different clinical problem and trainees should sample from a wide range of problem groups within the post • Immediate feedback will be provided after each encounter, by the observer rating the trainee • Trainers and trainees will need to identify and agree strengths, areas for development and an action plan for each encounter nMRCGP & WPBA introduction for clinical supervisors

  28. Directly Observed Procedures (DOPS) • Can occur at any point in training (Primary or Secondary care) • Opportunities to demonstrate some procedures might present more easily in secondary care (eg female genital examination in a gynaecology post) • Trainee chooses the timing, procedure and observer • A different observer should be chosen for each procedure • Observer should give feedback afterwards • Demonstrate DOP “when ready” • The mandatory procedures are considered sufficiently important to merit specific assessment nMRCGP & WPBA introduction for clinical supervisors

  29. Directly Observed Procedures (DOPS) 8 mandatory DOPS 11 optional DOPS Aspiration of effusion   Cauterisation Cryotherapy Curettage/shave excision Excision of skin lesions Incision and drainage of abscessJoint and peri-articular injections    Hormone replacement implants of all types/any types Proctoscopy Suturing of skin wound Taking skin surface specimens for mycology • Application of simple dressings • Breast examination                 • Cervical cytology • Female genital examination    • Male genital examination       • Prostate examination*        • Rectal examination* • Testing for blood glucose       *rectal and prostate exam may be combined in one DOP nMRCGP & WPBA introduction for clinical supervisors

  30. Multi Source Feedback (MSF) • 2 questions;- • Please provide your assessment of this doctor’s overall professional behaviour • Please provide your assessment of this doctor’s overall clinical performance • Answers on a 7 point rating scale (<very poor> to <outstanding>) • Space for freetext comments under headings • Highlights in performance (areas to be commended) • Possible suggested areas for development in performance nMRCGP & WPBA introduction for clinical supervisors

  31. Multi Source Feedback (MSF) • Trainee chooses raters to give MSF • Trainee gives raters a standard letter explaining • the process of MSF • how to complete the online assessments (inc the URL) • the date by which the assessment should be completed • Results of MSF go to trainer, who will give feedback to trainee • Results are anonymous, but educational supervisor (not trainer) will be aware of who the raters were, to ensure a good spread of different raters • Trainee then adds MSF to ePortfolio nMRCGP & WPBA introduction for clinical supervisors

  32. Clinical Supervisor’s Report • Downloadable from RCGP website nMRCGP & WPBA introduction for clinical supervisors

More Related