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What are the Work Place Based Assessments for GP trainees?

There are a variety of WPBAs and GP trainees are expected to complete a minimum number of each during each of their placements. Together these form a triangulated view of their progress to inform their Educational Supervisor and to provide evidence for panel to consider.

In hospital placements GP trainees will be particularly focused on getting their Case-based Discussions, Mini-cex's and Multi-Source Feedback completed. In Primary care ST1/2 placements trainees complete the same assessments except the Consultation Observation tool is used in place of the Mini-cex.

For more details on WPBA go to the RCGP website here.

What is a GP Case-based Discussion?

The CbD is a structured interview carried out by the Clinical Supervisor that requires preparation on both sides. The discussion itself should take approximately 30 minutes.

The trainee should provide two cases for potential discussion a week in advance to allow the assessor to consider the cases, select one for assessment, design suitable questions and identify the competencies that will be assessed. Note that a CbD will not assess all the competencies, you should aim to cover as many as sensible in the time available (usually a maximum of four).

The discussion should be focused on what actually happened and what the trainee did or understood. This is an assessment so this is the trainee’s opportunity to demonstrate strength and development in the selected competencies. The assessor should be asking questions that will help the trainee demonstrate these competencies. The assessor should not be questioning the trainee about what they could/should have done or what they will do moving forwards as this is an assessment.

Trainees are rated on their performance in this assessment only and it is expected that all trainees will need further development. You are encouraged to consider the trainee being assessed in relation to their peers. In order to achieve excellent as an ST1 or ST2 they will need to have demonstrated exceptional ability and insight.

Trainees have to carry out at least 3 CbDs in each post in ST1 and ST2 (6 per year) with a further 12 needed in ST3. However, it is sometimes sensible for trainees to do more to ensure that there is enough evidence for each competence.

What is a GP Consultation Observation Tool?

The COT is an assessment of a direct observation (usually a video) of a consultation carried out by a trainee in primary care placements only. Trainees need to complete three COTs for each six month primary care placement.

The Clinical Supervisor watches the video with the trainee and makes a judgement against the COT criteria. Not all the criteria will be marked and for some it may be that there is insufficient evidence in the selected consultation. However, the requirements are for a safe and patient centred approach throughout the consultation.

Trainees must remember to get the appropriate consent for videoing a consultation.

What is a GP Minicex?

These Clinical Evaluation Exercises assess clinical skills, attitudes and behaviours of GP trainees in secondary care settings instead of COTs. GP trainees must complete 3 miniCEX’s in every secondary care post. These assessments do not have to be carried out by Clinical Supervisors but they still must be done by an experienced colleague, any of the following are acceptable:

Staff grade doctor

Nurse Practitioner

Clinical Nurse Specialist

Speciality Registrar (ST4 or above)

Consultant

Trainees should be selecting miniCEXs that demonstrate different clinical problems to ensure there is a wide variety of evidence by the time they have completed their training in secondary care.

MiniCEX are ‘snap shots’ of evidence of GP trainees interacting with secondary care patients with a selected focus on either

History

Diagnosis

Management

Explanation

Feedback should take about 15 minutes and should include production of an agreed action plan for the trainee’s future development.

Trainees are rated on their performance in this assessment only and it is expected that all trainees will need further development. You are encouraged to consider the trainee being assessed in relation to their peers. In order to achieve excellent as an ST1 or ST2 they will need to have demonstrated exceptional ability and insight.

What is a GP Multi-Source Feedback?

The MSF is a tool to collect colleague opinions on clinical performance and professional behaviour. It forms a part of the evidence that panel use to assess competence and also provides a useful reflection tool for trainees.

Trainees have to complete two cycles of MSF in ST1 (one during each post) and a further two in ST3. Therefore, every trainee will have a minimum of one completed in a hospital placement.

In secondary care GP trainees will need responses from five clinicians with different job titles all of whom should have observed the trainee in the workplace. Trainees are usually advised to ask more than five to ensure the minimum number of responses is met to validate the assessment tool. Colleagues who have been asked will be given a ‘ticket’ code which can be entered by clicking on ‘Assessment forms’ under the trainee eportfolio log in.

Responses to the MSF remain anonymous so no-one has access to find out the author of comments on the questionnaire.

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