Modernising Medical Careers for GPs Education Supervision and Review of Progression

Modernising Medical Careers

The Principles of MMC Trainees enter run through training on completion of foundation programme Training throughout the programme to meet requirements of the curriculum Completion of the programme is competency based (though minimum time set) Certification of completion of training (CCT) awarded on completion

Principles of WPBA Longitudinal assessment of each trainee’s progress over 3 years Multiple sampling using workplace based assessment tools Tools look at developmental progression Links to RCGP Curriculum Learner led Competencies demonstrated when ready

Implementation of WPBA All learning and assessments recorded in e-portfolio Regular educational supervision –GP based Annual review of progression –Deanery panel

Workplace Based Assessment Externally and locally assessed components Assessed by clinical supervisor in hospital or general practice setting Demonstrate progression rather than pass or fail for individual assessments

Locally Assessed Components Case based discussion CbD Consultation observation tool COT Mini CEX (Clinical evaluation exercise) Directly observed procedure (DOPs)

Externally Assessed Components Multi-source feedback (MSF) –2 domain questionnaire using both clinical and non-clinical colleagues Patient satisfaction questionnaire (PSQ) –Empathy questionnaire (CARE) – assessed components

Educational Supervision 6 monthly review –Done at end of posts 1 and 3 or mid ST3 –WPB Assessments and results –Coverage of curriculum –Clinical supervisors report –Review PDP –Produce PDP for next 6 months –Complete report on e-portfolio

Educational Supervision Annual Review –For ST1&2 done at month 10 or 11 of year –Educational supervisor meeting and report as 6 month review –Annual NHS appraisal – documentation automatically produced by e-portfolio –Put Trainee forward for Deanery Panel with recommendation Satisfactory progress Panel review requested e.g. some ill defined concerns, Unsatisfactory progress

Annual Review of Competency Progression Done by a panel convened by the Deanery 5 panel members with representatives of educators, employers, lay and RCGP Panel members not involved in trainees programme Quality management of assessment and review processes

Annual Review of Competency Progression For trainees progressing satisfactorily –Review of e-portfolio summary only For trainees with development needs –Full review of e-portfolio –Decision on further education plan –Interview with trainee

Educational Appraisal Annual Review of Competence Progression Outcome Annual Planning 1. Learning agreement: aims & intended learning outcomes based on specialty curriculum 2. Advice on portfolio 3. Regular feedback (2 way) 4. Personal Development Plan 5. Trainer’s structured report 6. Workplace based (NHS) appraisal Educational supervisor and/or TPD meet with trainee to review competence outcome with trainee plan next part of training Based on a paper from PMETB’s Workplace Assessment Group (2005 ) Workplace based (NHS) appraisal ARCP A. Evidence 1. Assessment of performance e.g. workplace based assessments and observational methods E.g. mini-CEX, DOPS, video, CBD examinations structured report 2. Assessment of experience, e.g. portfolio/log book audit research critical incidents B. Annual Competence Review Appropriately constituted panel considers evidence Outcome Review of evidence of progress Outcome of review Educational Planning

Completion of Training Demonstrate competency through WPBA. Pass AKT and CSA Experience prior to Aug 07 certified by VTR forms Deanery Panel recommends eligibility for Certificate of Completion of Training (CCT) Recommendation confirmed by RCGP certification unit to PMETB PMETB issues CCT

Certification Article 10 – Certificate of Completion of Training (CCT) Article 11 – Certificate of Eligibility for GP Registration (CEGPR) –Posts not approved for GP training –More than 7 years prior to completion date –Overseas experience

The Principles of MMC Trainees enter run through training on completion of foundation programme Training throughout the programme to meet requirements of the curriculum Completion of the programme is competency based (though minimum time set) Certification of completion of training (CCT) awarded on completion

Terminology Old GP Registrar………. SHO………………… Course Organiser… Scheme Organiser.. Day Release Course GP Trainer…………. New GP Specialty Registrar (GP StR3) GP Specialty Registrar (GP StR1 or 2) Primary care medical educator Programme Director Structured Teaching Programme GP Trainer Educational Supervisor Clinical Supervisor

Implications for General Practice All trainees on 3 year programme Self construct schemes and stand-alone registrar posts ended July 2007 GP training programmes have expanded and need to expand further by absorbing current posts Programmes approved by PMETB

Implications for General Practice 50% of trainees completing F2 will enter GP training Acquisition of hospital posts for GP programmes All trainees starting 2008 should have 18 months in GP –Integrated training posts (ITP) –Full GP posts

Projected numbers Year2 yr progs 3 year progs ST 1 & 2 posts Trainers needed ST3 24 ITP ST3 95 ST ? ST3 105 ST2

Summary GP Curriculum GP Specialty training in 3 year integrated programmes Ongoing assessment, appraisal and education supervision Expansion of numbers and time in GP