Workplace Based Assessments For Trainees In General (Internal) Medicine Workplace Based Assessments (WBAs) have become a fundamental part of the process of assessment of medical trainees. WBAs involve the assessment of competence based upon what is actually done in the workplace. The aim of WBAs is to aid learning by providing trainees with constructive feedback. They can be used to document progress both during individual placements and also across the whole of an individual’s training programme. WBAs have become a very useful tool to inform/support the formal assessment processes (RITA and ARCP).

There are currently three types of trainees undertaking Higher Specialist Training in General (Internal) Medicine (GIM)

  • Specialist Registrars (SpRs), who would have been appointed up to July 2007;
  • Speciality Registrars (STRs) appointed between August 2007 and July 2009, who will be training in GIM according to the General Internal Medicine Curriculum 2007
  • Speciality Registrars (STRs) appointed from August 2009, who will be training in GIM according to the 2009 GIM

Curriculum

There has been some concern and confusion about which WBAs are necessary for which type of trainee; this has been a particular issue for SpRs. The following will hopefully clarify matters:

  • STRs should follow the relevant instructions regarding which WBAs to undertake: STRs on the 2007 GIM curriculum should refer to the document “GIM (Acute) ARCP decision aid” on the JRCPTB website; STRs from August 2009 should refer to the 2009 GIM curriculum document.
  • SpRs should undertake the following WBAs in GIM during each year that they are training in GIM:
  1. 4 x CbDs (minimum), 4 x mini-CEXs (minimum), 2 x ACATs (minimum) 1 x MSF should be undertaken on alternate years (the MSF is a generic, rather than GIM or specialty assessment)
  2. DOPS in GIM procedures until you have been signed off as competent (i.e. if you have been signed off in a procedure at an earlier stage in training, no further DOPS are required); most trainees will have completed GIM DOPS by this stage
  3. Trainees who are doing a non GIM year of training will not be expected to undertake GIM WBAs during that year, unless they are looking to count some of that time towards their GIM CCT (eg if they participate in a GIM on-call rota). 

Assessment Processes:

  • STRs will undergo the Annual Review of Competence Progression (ARCP); a part of this process will be to determine whether the correct number of appropriate WBAs have been undertaken during the previous year. Failure to complete adequate WBAs will potentially lead to an adverse outcome.
  • SpRs will undergo the Review of In-Training Assessment (RITA), a part of which will be to determine whether the correct number of appropriate WBAs have been undertaken during the previous year. Failure to complete adequate WBAs will potentially lead to a RITA ‘D’, with a set time period to complete any outstanding WBAs.
  • All trainees in GIM will undergo a Penultimate Year Assessment (PYA), which is either a RITA or ARCP including an external assessor, at which time the previous year’s GIM work will be assessed (including WBAs) and any final year training requirements needed to acquire a CCT in GIM will be stipulated.