1. FP Curriculum 2012: summary of key changes that will impact the FP e-portfolio Intended audience: The educational faculty (e.g. supervisors, FTPD/Ts, FSDs, FSMs) Miss Stacey Forde UKFPO Project Manager April 2012

2. Setting the scene  This presentation is not a substitute for reading the new Curriculum 2012!  A selection of the key changes will be explored. FULL details are available within the FP Curriculum 2012, the UKFPO website & the ‘Key Changes’ handout.  Many key changes involve new administrative processes with revised forms to support Curriculum delivery.  New forms and processes will largely be managed via the e-portfolio, hence greater e-portfolio engagement is required (especially by supervisors).  There is a wealth of supporting guidance notes available on the UKFPO website.

3. So why a new Curriculum?  Prof. John Collins’ report ‘Foundation for Excellence’ highlighted many positive aspects of the Curriculum but also these particular areas of concern: 1) The purpose of foundation training 2) The value of F2 training 3) Long term condition management 4) Excessive assessments  To align to the GMC Trainee Doctor (2011)  The AoMRC were tasked to address these matters and as a result produced the FP Curriculum 2012.

4. Summary of key changes to be explored:  New Curriculum syllabus headings  High level descriptors to distinguish between F1 and F2 outcomes  Supervised learning event (SLE) forms and guidance introduced  Changes to assessment  Detailed clinical supervisor’s end of placement report  Detailed educational supervisor’s end of placement & end of year report  Introduction of foundation-ARCP process and forms  Sign off documents reformatted into certificates

5. New Curriculum syllabus headings The FP Curriculum syllabus headings have been rationalised from 16 (as listed below) to 12 overarching headings.

6. High level descriptors to distinguish F1/F2  High level descriptors separating the differences between the outcomes for satisfactory completion of F1 and F2 1.2 Time management F1 outcome Is punctual and organised F2 outcome (in addition to F1) Delegates tasks and ensures that they are completed Competences Is punctual for all duties, including handovers, clinical commitments and teaching sessions Integrates Supervised Learning Events and other learning responsibilities into the weekly programme of work Keeps a list of allocated tasks and ensures that all are completed Organises and prioritises workload regularly and appropriately Delegates or calls for help in a timely fashion when falling behind Demonstrates the ability to adjust decision-making in situations where staffing levels and support are reduced (e.g. out of hours)

7. Supervised learning event (SLE):  A SLE is an interaction between a foundation doctor and a trainer which leads to IMMEDIATE feedback and reflective learning.  They are designed to help foundation doctors develop and improve their clinical and professional practice and to set targets for future achievements.  SLEs are based on workplace-based assessment tools but performance descriptors have been removed and comment is via white box spaces for immediate feedback and developmental action points.  SLE tools:  Mini-clinical evaluation exercise (mini-CEX)  Direct observation of procedural skills (DOPS)  Case-based discussion (CBD)  Developing the clinical teacher.

8. Supervised learning event (SLE):  Recommended minimum number of SLEs as per FP Curriculum 2012 : SLE toolRecommended minimum number (may increase/vary locally) Direct observation of doctor-patient interaction:  Mini-CEX  DOPS  3 or more per placement*  Optional to supplement mini-CEX (9 per year; at least 6 using mini-CEX) Case-based discussion (CBD)2 or more per placement* Developing the clinical teacher1 or more per year * based on a clinical placement of 4 month duration (as per Collins recommendations)

9. Assessment tools: Assessment toolFrequency Core proceduresThroughout F1 (optional in F2) Team assessment of behaviour (TAB)Once in first placement* in both F1 and F2 (optional repetition) (Self-TAB remains mandatory) Clinical supervisor’s end of placement report Once per placement* Educational supervisor’s end of placement report Once per placement* Educational supervisor’s end of year report Once per year  Assessment has changed. Revised forms and guidance introduced: * based on a clinical placement of 4 month duration (as per Collins recommendations)  Clinical & Educational supervisor engagement with the e-portfolio is paramount.

10. Clinical supervisor’s end of placement report  Clinical supervisor’s end of placement report The clinical supervisor (supported by a Placement Supervision Group) takes responsibility for accurately describing the foundation doctor’s performance in the workplace and highlighting any areas of excellence or concern which may require educational support.  Placement Supervision Group Consists of doctors more senior than F2, including at least one consultant or GP principal, senior nurses (band 5 or above) and allied health professionals. Responsible for:  observing the foundation doctor’s performance in the workplace  providing feedback on practice to the foundation doctor  providing structured feedback to the named clinical supervisor  undertaking and facilitating supervised learning events (SLEs).

11. Clinical supervisor’s end of placement report ProfessionalismExcellent □ No concern □ Some concern □ Major concern □ N/A □ Please comment on the foundation doctor’s areas of excellence or areas of any concern under the following headings. Be as specific as possible. Comments:  Behaviour in the workplace...............  Time management............................  Continuity of care...........................  Team working........................  Leadership........................  The CS’s end of placement report is a detailed assessment.  The CS will need to :  Complete names and job title/grade of PSG members who contributed  List evidence used to inform assessment  Assess the doctor’s performance using the overarching syllabus headings  Provide an overall assessment and comments on performance.

12. Educational supervisor assessments:  There are two assessments that the ES will need to complete:  Educational supervisor’s end of placement report The educational supervisor assesses the foundation doctor by reviewing evidence and records if there are any areas of excellence or concerns.  Educational supervisor’s end of year report This review draws together all evidence gathered throughout the year to enable a recommendation for satisfactory sign off to be made.

13. Educational supervisor’s end of placement report  The ES is required to assess the below: Evidence considered and assessment rating: ExcellentNo concern Some concern Major concern Unable to comment Please provide comment on any areas of excellence or concern Assessments: Clinical supervisor’s end of placement report* TAB Core Procedures Engagement in learning:** E-portfolio Engagement in Supervised Learning Events (SLEs) Attendance at formal educational events Overall judgement of placement performance compared to a doctor ready to complete F1/F2 ExcellentNo concern Some concernMajor concern  There are also free text areas to comment on:  other achievements made by the foundation doctor  any areas that need to be prioritised in the foundation doctor’s next placement  any other comments

14. Educational supervisor’s end of year report: Educational supervisor’s end of year report  The end of year report draws upon all evidence and progression demonstrated throughout the year.  The ES recommends if the foundation doctor HAS or HAS NOT met the requirements for satisfactory completion of the F1/F2 year as laid down by the GMC and set out in the Foundation Programme Curriculum 2012 and the Foundation Programme Reference Guide 2012.  The e-portfolio will host optional documents to aid judgement of meeting satisfactory requirements:  checklist of requirements for satisfactory completion of F1/F2 (as per FP Reference Guide 2012)  summary of outcomes achieved document.

15. Sign off / FP ARCP process 2013 Introduction of Foundation Programme ARCP (FP ARCP)  FP ARCP panel (FTPD/T and two others) will review if a doctor has satisfactorily met the requirements for sign off.  IMPORTANT: All members of the panel will need read-only access to the e-portfolio.  The information flow and FP ARCP process will be underpinned by use of the e-portfolio.  ‘Interim Review of Competence Progression’, ‘Checklist of satisfactory requirements for F1/F2’ & ‘Summary of outcomes achieved’ forms are OPTIONAL features to support sign off.  The F1 & F2 sign off documents (5.1 and 5.2/FACD) are now certificates that can be printed onto local headed paper.

16. Sign off / FP ARCP process 2013 Throughout the F1/F2 year: Assessments, SLEs, meetings, ES’s end of placement reports & CS’s end of placement reports completed. Towards the end of the year: ES’s end of year report recommends if requirements for satisfactory completion of F1/F2 have been met. (Note: ES not required to complete end of placement report when completing end of year report) End of year: FP ARCP panel convened (FTPD/T & two others). Panel to review ES’s end of year report and e-portfolio evidence (can be remote). Panel to assign outcome. Recommended for sign off Outcome 1: Satisfactory completion of F1 Outcome 6: Satisfactory completion of F2 NOT recommended for sign off Outcome 3. Inadequate progress – additional training time required Outcome 4. Released from training programme Outcome 5. Incomplete evidence presented – additional training time may be required Sign off form SIGNED/ISSUED Sign off form NOT SIGNED/ISSUED. Other action taken.

17. Sign off / FP ARCP process 2013  The FP ARCP process is designed to enhance the sign off process and does not generate additional work for supervisors.  The existing principles of sign off have not been affected. What has NOT changed?What has changed? The FTPD/T retains responsibility to review the e-portfolio and confirm if a doctor has met requirements for satisfactory completion of F1/F2. An additional person is recommended to form part of the review panel i.e. the ARCP panel consists of the FTPD/T (as chair) & 2 others. The panel can conduct the review remotely. A panel should review e-portfolio of any doctor who is at risk of not meeting/has not met the requirements for satisfactory completion of F1/F2 and should make recommendations for remedial/additional action. ARCP codes (as used for specialty) are now used to better describe the outcome of the panel.

18. E-portfolio access Job TitleAccess LevelAccess Duration Foundation doctorAll own data only Indefinitely Clinical supervisorShared e-portfolio content for specified foundation doctors in a particular placement of a particular foundation programme During the period of supervision and for a period of three months following the end of the placement Read-only: indefinitely Educational supervisorShared e-portfolio content for specified foundation doctors in a particular year of a particular foundation programme During the period of supervision and for a period of three months following the end of the year Read-only: indefinitely Foundation training programme director/tutor (FPTD/T) and nominated administrator Shared e-portfolio content for specified foundation doctors in a particular foundation programme During the Foundation Programme and for a period of three months following the end of the programme Postgraduate dean, foundation school director (FSD), foundation school manager (FSM), and other nominated administrators Shared e-portfolio content for all foundation doctors in a particular foundation school During the Foundation Programme and for a period of three months following the end of the programme Read-only: Indefinitely. Information should be archived E-portfolio provider / system administratorAll data for all users subject to approval by the postgraduate dean For such periods as approved by the postgraduate dean

19. Key messages:  Clinical & Educational supervisor engagement is paramount to the success of delivering the FP Curriculum 2012.  The UKFPO hosts a wealth of guidance and information to support the transition from FP Curriculum 2010 to 2012. We are here to support you. If you require anything in particular, please contact: Stacey.forde@foundationprogramme.nhs.uk Stacey.forde@foundationprogramme.nhs.uk  The AoMRC, UKFPO, e-portfolio providers, FP Curriculum Delivery Group and all other stakeholders continue to work hard to ensure that the FP Curriculum, Reference Guide and supporting e-portfolio products enhance the Foundation Programme experience.  If you have any good practice examples of Curriculum delivery; the UKFPO would like to hear from you. Please contact: enquiries@foundationprogramme.nhs.uk enquiries@foundationprogramme.nhs.uk  Thank you.