Workplace Based Assessments (WPBA)
WPBAs were introduced for all SpRs & StRs in 2005. WPBAs are formative learning experiences, i.e. an opportunity to perform a clinical encounter and gain valuable insights into your strengths, weaknesses and ways to further develop. They are a valuable training opportunity with your consultant and time should be set aside to make best use of these. The assessments are not summative and therefore represent ongoing training and learning, not just 'signing you off'.
The minimum number of WPBAs needed, at each particular stage of training, are summarised below:
All SpRs & StRs appointed prior to August 2010:
All StRs appointed substantively on or after August 2010:
General Internal Medicine
SpR appointed up to July 2007
For each year that you are training in GIM it is recommended that the following are done:
4 x CbDs (minimum)
4 x mini-CEXs (minimum)
2 x ACATs (minimum)
1 x MSF should be undertaken on alternate years
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
StR appointed August 2007 to July 2009: http://www.jrcptb.org.uk/specialties/st3-spr/pages/general-internal-medicine.aspx
StR appointed after August 2009 or StR appointed after August 2007 who has transferred to the new curriculum
P183-4 of Aug 2009 GIM curriculum
The MSF is a generic assessment, rather than GIM or specialty specific
Trainees who are doing a non-GIM year of training will not be expected to undertake GIM WPBAs 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)
It is mandatory for trainees to complete all their assessments on line via ePortfolio and all endoscopy DOPS & trainer feedback via endoscopy ePortfolio (see below).
Direct Observation of procedural skills (DOPS)
A DOPS is an assessment tool designed to evaluate the performance of a trainee in undertaking a practical procedure, for example endoscopy, against a structured checklist. The trainee receives immediate feedback to identify strengths and areas for development. DOPS are either formative or summative. Formative DOPS are carried out throughout training and are used to aid learning. A minimum of 10 formative DOPS each year should be completed for each endoscopic procedure you are training in. When the trainee has completed the number of procedures recommended by JAG, and it is agreed between trainee and trainer that competence has been achieved, summative DOPS should be completed by at least 2 independent trainers (not your current trainer) on at least 2 separate procedures. Summative DOPS is used to grade you as competent in a procedure or not. This can occur with diagnostic and therapeutic OGD, colonoscopy and ERCP. Six DOPS on paracentesis should be completed throughout training.
The JAG accreditation criteria & grade descriptors can be found at http://www.thejag.org.uk/Forms/tabid/72/Default.aspx
Endoscopy portfolio, DOPS and trainer feedback can be recorded via the JETS endoscopy e-portfolio.
Mini-Clinical Evaluation Exercise (Mini-CEX)
This tool evaluates a clinical encounter with a patient to provide an indication of competence in skills essential for good clinical care such as history taking, examination and clinical reasoning. The trainee receives immediate feedback to aid learning. They can be used at any time and in any setting when there is a trainee and patient interaction and an assessor is available.
Case Based Discussion (CbD)
The CbD assesses the performance of a trainee in their management of a patient to provide an indication of competence in areas such as clinical reasoning, decision- making and application of medical knowledge in relation to patient care. It also serves as a method to document conversations about, and presentations of, cases by trainees. The CbD should focus on a written record (such as written case notes, out-patient letter, discharge summary). A typical encounter might be when presenting newly referred patients in the out-patient department.
Multi-source Feedback (MSF) or mini-PAT (360° assessment)
This tool is a method of assessing generic skills such as communication, leadership, team working, reliability etc, across the domains of Good Medical Practice. This provides objective systematic collection and feedback of performance data about you, derived from a number of colleagues. ‘Raters’ are individuals with whom you work, and include doctors, administration staff, and other allied professionals. You will not see the individual responses by raters, feedback is given to you by your Educational Supervisor.
It should be carried out at end of years 1 and 3 and additionally only if there are concerns. You should obtain people from all areas of work to rate you using e-portfolio. A summary is created & released to you by your educational supervisor.
Acute Care assessment Tool (ACAT)
The ACAT is designed to assess and facilitate feedback on a doctor’s performance during their practice on the Acute Medical Take. Any doctor who has been responsible for the supervision of the Acute Medical Take can be the assessor for an ACAT. It measures eight domains for example clinical assessment, record keeping and handover. The ACAT is trainee led (choosing the take period and may be observed by a consultant) and takes no more than 15 minutes. This is a ‘formative’ assessment.
Patient Survey (PS)
Patient Survey address issues, including behaviour of the doctor and effectiveness of the consultation, which are important to patients. It is intended to assess the trainee’s performance in areas such as interpersonal skills, communication skills and professionalism by concentrating solely on their performance during one consultation.
Audit Assessment (AA)
The Audit Assessment tool is designed to assess a trainee’s competence in completing an audit. The Audit Assessment can be based on review of audit documentation OR on a presentation of the audit at a meeting. If possible the trainee should be assessed on the same audit by more than one assessor.
Teaching Observation (TO)
The Teaching Observation form is designed to provide structured, formative feedback to trainees on their competence at teaching. The Teaching Observation can be based on any instance of formalised teaching by the trainee which has been observed by the assessor. The process should be trainee-led (identifying appropriate teaching sessions and assessors).