The following methodsare used as part of the integrated assessment system:
The aim is to assess atrainee’s knowledge and understanding of the clinical sciences relevant tospecialist medical practice and of common or important disorders to a levelappropriate for a newly appointed consultant. Information about SCE, includingguidance for candidates, is available on the MRCP(UK) website www.mrcpuk.org
Workplace-basedassessments (WPBA) will take place throughout the training programme to allowtrainees to continually gather and demonstrate evidence of learning and toprovide informative feedback. They are not individually summative (i.e. notpass/fail) but will form overall outcomes from a number of such assessments andprovide evidence towards decision making. The WPBAs must be spread evenlythroughout the training year.
This tool is a method of assessinggeneric skills such as communication, leadership, team work and reliability. This provides objective systematic collectionand feedback of performance data on a trainee, derived from a number ofcolleagues. ‘Raters' are individuals with whom the trainee works, and includesdoctors, administration staff, and other allied professionals. The trainee willnot see the individual responses by raters. Feedback is given to the trainee by theirEducational Supervisor.
The mini-clinical evaluation exercise (mini-CEX) is a tool which evaluates a clinicalencounter with a patient to provide an indication of competence in skills whichare essential for good clinical care such as history taking, examination andclinical reasoning. The trainee receives immediate feedback to aid theirlearning. The mini-CEX can be used at any time and in any setting when there isa trainee and patient interaction and an assessor is available.
The case-based discussion (CbD)assesses the performance of a trainee in their management of a patient toprovide an indication of competence in areas such as clinical reasoning,decision-making and application of medical knowledge in relation to patientcare. It also serves as a method to document conversations and presentationsabout cases by trainees.
TheCbD should focus on a written record (Such as written case notes, out-patientletter, discharge summary). A typicalencounter might be when presenting newly referred patients in the out-patientdepartment.
PatientSurvey address issues, including behaviour of the doctor and effectiveness ofthe consultation, which are important to patients. It is intended to assess thetrainee’s performance in areas such as interpersonal skills, communicationskills and professionalism by concentrating solely on their performance duringone consultation.
A formal process ofappraisals and reviews underpins training. This process ensures adequatesupervision during training provides continuity between posts and different supervisors and is one of themain ways of providing feedback to trainees.
The trainee and educationalsupervisor should have an appraisal meeting at the beginning of each post to review the trainee’s progressso far, agree learning objectives for the post ahead and identify the learningopportunities presented by the post. Reviewing progress through the curriculumwill help trainees to compile an effective Personal Development Plan (PDP) ofobjectives for the upcoming post. This PDP should be agreed during theInduction Appraisal. The trainee and supervisor should also both sign theeducational agreement in the e-portfolio at this time, recording theircommitment to the training process.
This meeting between traineeand educational supervisor is mandatory (except when an attachment is shorterthan 6 months), but is encouraged particularly if either the trainee or educationalor clinical supervisor has training concerns or the trainee has been setspecific targeted training objectives at their ARCP. At this meeting traineesshould review their PDP with their supervisor using evidence from thee-portfolio. Workplace-based assessments and progress through the curriculumcan be reviewed to ensure trainees are progressing satisfactorily, andattendance at educational events should also be reviewed. The PDP can beamended at this review.
Trainees should review thePDP and curriculum progress with their educational supervisor. Specificconcerns may be highlighted from this appraisal. The end of attachment / end ofyear appraisal form should record the areas where further work is required toovercome any shortcomings. If there aresignificant concerns following the end of attachment / end of year appraisalthen the programme director should be informed.