1. Workplace Based Assessment Eportfolio new curriculum

2. Completing WPBAs in the workplace Kaizen
Overview
Overview of WPBAs
Completing WPBAs in the workplace
Kaizen
Utilising the Return to work checklist
New Curriculum

3. What are WPBA’s They Are..... They are not.....
“an essential part of an assessment system alongside traditional examination” – GMC
an opportunity for the trainee to receive feedback, reflect and develop
mandatory
a valuable tool to promote active learning
They are not.....
a pass/fail assessment
going away!

4. Assessment Table
As you can see across the top we have the level of the trainee and down the left hand side the type of assessment and the required number at each Level starting with SLE’s, then AoP’s and then the other assessments such as START which contribute to the ARCP
So for example Mini-CEX and CbD’s – at Level 1 - aim for 20 but a minimum of 12 per year and a suggested ratio of 2 Mini-CEX’s for CbD carried out
This is available on the Assessment page of the College website.
We will be releasing clear ARCP guidance following the next Quality Committee meeting in November.
Changes are from Sept 1st so any trainees that have already been signed off as competent in DOPS are “in the bank”
OOPE does not require assessments but OOPT does. Trainees encouraged to maintain Eportfolio during OOPE.

5. Make them useful to your training
Mini-CEX
Ward round; Clerking; Communication
Introduce mini-cex ward round
No min
CBD
A case you want to discuss
Safeguarding
Photocopy the notes
1/yr
LEADER-CBD
Leadership
Effective services
Acting in a team Direction setting Enabling improvement
Reflection
Leading resus
Idea for service improvement
MDT working
Clinical governance
Use it to discuss a QI project
1/yr in Level 2 and 3
HAT
Ward handover
Handover to retrieval team
Review components required first
1 in level 1
2 in level 2
ACAT
Integrating clinical and non-clinical skills
Ward round, A+E/NICU shift
1 in level 2
DOC
Effective written communication
Discharge letters, clinic letters, referrals
Save copy and send to supervisor
5 in level 2
5 in level 3
The good news is that doing these hasn’t changed very much.
However recording of the assessment has changed.
Scoring has gone. The essential feature is that feedback should be recorded and suggestions for development made. Although a broad judgement is made about whether the learning needs identified are appropriate for the stage of training, No attempt to define specific performance level is made. If the learning needs are more extensive than would be expected at that stage of training, a significant concern can be recorded which alerts the educational supervisor. This can be taken into account at educational supervision meetings, may even trigger an extra one, and triangulated with other aspects of training. Ultimately it may influence the trainers report but we would not expect a serious concern that had been adequately addressed to have adverse consequences unless there were other concerns.
Case selection – important. Something to learn from. Something that caused anxiety, concern, found challenging, recorded as an incident likely to be more rewarding and valuable as learning.
One important enhancement is that an assessor can initiate the assessment, and record the result without waiting for an invitation (although trainee must know they are being assessed!).
The trainee would also reflect on the assessment (maybe only briefly)
We also want SLes to be very flexible – Any aspect of work can be assessed. Mini CeX is very flexible. The exact number performed by each trainee will vary, and in the ideal set up this would be according to training needs of the individual

6. Compulsory DOPs
Trainee must be competent to perform the procedure unsupervised
DOPs repeated until satisfactory level achieved
Compulsory DOPs (must be assessed by a consultant):
Bag, valve and mask ventilation
Peripheral venous cannulation
Lumbar puncture
Tracheal intubation of term and preterm babies
Umbilical venous cannulation
Complete by end of level 1
Non-compulsory DOPS can be assessed by a more senior trainee or a senior nurse etc that is competent themselves at the procedure
They should be recorded in the skills logon eportfolio

7. The rest……. ePaed MSF Online Multi-Source Feedback Complete 1/year
ePaed CCF
Carers for Children Feedback
Specialty Trainee Assessment of Readiness for Tenure (START)
Completed in Level 3 training (ST7)
Two sessions a year
Cost £250
Carers for Children Feedback. Feedback sought from parents/carers. Used as an additional tool when required. An important tool used for Consultant revalidation

8. ePortfolio Kaizen kʌɪˈzɛn/
a Japanese business philosophy of continuous improvement of working practices and personal efficiency
Single sign on (SSO)
Dashboard
Timeline – can search and filter
Events – all training forms and assessments
Tag events with curriculum items and documents
To do list
Add your own supervisor

9. ePortfolio

10. ePortfolio Development log
Reflective practice/critical incident: 2 per 6 mths
Must declare involvement in any SI/complaints at ARCP
Clinics: 10 per 6 mths (5 if neonatal job)
Governance: 1 QI/audit/guideline per yr
Courses, Safeguarding, Clinical Question, Education Meetings, Management, Research, Teaching, Presentations
Try and log in real time

11. ePortfolio Curriculum mapping – why is it important?
Record of training – achievement of required competences
Learning tool – identify learning needs and helps to formulate PDP

12. Introducing…the new curriculum
<introduce self>
I’ll be doing a short presentation for you explaining why RCPCH has updated the curriculum, what’s changed, and how this will impact you. If you’ve got any questions then I’ll be happy to answer them at the end of the presentation.

13. Why Progress?
The new curriculum is based on a framework of learning outcomes as opposed to the current list of competencies, and incorporates the Generic Professional Capabilities the GMC expect of all doctors
So why did RCPCH decide that the curriculum for paediatric training needed revising? We think (*) this picture sums up what trainees and trainers think of the current one.
It’s a beast of a document, hundreds of pages long. David Evans, our Vice President for Training & Assessment, worked out that if every trainee were to print the whole curriculum, it would cover 60 rugby pitches.
Feedback has been that it is unwieldy, and not easy to use. We have around 2500 bullet points listing competencies (*), every kind of procedure or disease you might ever encounter, but it doesn’t clearly articulate what it means to be a good paediatrician. Trainees and trainers have told us they’re not sure what the standard is that they need to meet, and how much evidence they need to show.
We know that your time is under ever increasing pressure, and so it’s important when you do have time for education and training you can spend that more valuably, not wading through mountains of paperwork trying to make sense of the curriculum.
Image: clipart papermountain1.jpg and oV2PM.png (tick boxes)

14. Progress curriculum domains
11 generic curriculum domains:
Professional values and behaviours
Professional skills and knowledge: communication
Professional skills and knowledge: procedures
Professional skills and knowledge: patient management
Health promotion and illness prevention
Leadership and team working
Patient safety (including safe prescribing)
Quality improvement
Safeguarding
Education and Training
Research
These are framed around the GMC’s Generic Professional Capabilities that all trainees will need to demonstrate.
The new curriculum is structured around 11 distinct themes, known as domains.
These domains have been drawn from the GMC’s Generic Professional Capabilities, which are things that all trainees in all specialties will need to demonstrate as they progress through and complete their training. Our Learning Outcomes have taken those capabilities, and contextualised them so they are most relevant for paediatrics.

15. Progress Learning Outcomes
Domain
Level 1
Level 2
Level 3
Professional values and behaviours
In addition to the professional values and behaviours required of all doctors (Good Medical Practice), a paediatric trainee maintains confidentiality but can distinguish when disclosure may be required in relation to safeguarding.
Can summarise the specific legislation which applies to children and families.
Acts as a role model and guides junior colleagues in developing professional values and behaviours in relation to paediatrics.
Creates an open and supportive working environment.
Adheres to current legislation related to children and families e.g. adoption, safeguarding etc.
Adopts a self-regulatory approach to their behaviour and demonstrates the professional qualities required by a paediatrician undertaking independent practice.
Professional skills and knowledge (Communication)
Develops effective relationships with children and families and colleagues, demonstrating effective listening skills, cultural awareness and sensitivity.
Communicates effectively in the written form, by means of clear, legible, and accurate written and digital records.
Participates effectively in the multi-disciplinary team.
Engages with patients and families, facilitating shared decision-making.
Recognises complex discussions and when to seek assistance.
Leads multi-disciplinary teams and demonstrates effective communication skills in a range of environments and situations with children, young people and families in challenging circumstances.
Communicates effectively with external agencies, including authoring legal documents and child protection reports.
And this is what it looks like. For each of those 11 domains, there is a Learning Outcome describing the standard the trainee needs to evidence by the end of Level 1, Level 2 and Level 3. The 60 rugby pitches worth of curriculum have been replaced by this grid, which with all 11 domains is just over 2 pages long.
These Learning Outcomes will be the focus of trainee evidence in ePortfolio, and the Educational Supervisor reports at the end of each year.
All trainees will need to achieve all 11 Learning Outcomes at each level, so 33 in total throughout paediatric training.
Their supervisors will consider the evidence they have for each Learning Outcome, and make a judgement as to whether the standard outlined has been met.

16. Introductory Statement
The syllabi
Key capabilities are mandatory to achieve the Learning Outcome and must be evidenced clearly in e-portfolio
Illustrations are examples of evidence and give the range of clinical context the trainee may use to support their achievement of the Learning Outcomes
Introductory Statement
Learning Outcome
Key Capabilities
IIlustrations
Assessment Grid
To help give clarity as to what it means to have adequately demonstrated the Learning Outcomes we’ve produced the syllabi that explain each in more detail.
These will help trainees recognise which areas they’re strong in and are beginning to meet the standard required, and where their gaps or areas where they need to focus their development are.
It will also help Supervisors to make a judgement on whether their trainee has met each Learning Outcome, and hopefully it will improve consistency across the different schools.
The key elements of the syllabi are the key capabilities and illustrations. Key capabilities are mandatory things that must be demonstrated in order to achieve the Learning Outcome. Illustrations are examples of other evidence that the trainee may use to help demonstrate to their Supervisor that they have met the Learning Outcome.

17. The syllabi
That all sounds a bit abstract, but this is what it looks like on a page. This is an example page from the Level 1 syllabus, and focuses on the Level 1 Learning Outcome on Patient Management.
The Learning Outcome, which is the overarching standard the Supervisor is judging the trainee against, is in the first box.
Below this, are two key capabilities. The trainee must have demonstrated these explicitly in order to achieve the Learning Outcome.
However, on their own they may not provide enough evidence for the supervisor to feel confident that the trainee has met the whole Learning Outcome. The illustrations would be useful in this case, with supervisors using them to guide the trainee as to what other evidence would help demonstrate achievement.
They may also be useful for trainees who have done something interesting or challenging and want to record it but aren’t sure how it relates to the curriculum. The illustrations will help them decide which area it best evidences, and it can be recorded accordingly.
You can see the start of the list of illustrations at the bottom of the screen, below the key capabilities. Some of the lists of illustrations are quite long, but remember they are only examples. Trainees are not required to do all, or even any, of the illustrations, they are just our suggestions of the other kind of evidence they may want to include.

18. Assessment strategy
Blueprint and assessment tools unchanged, but will be used differently – centred on the Learning Outcomes, and greater focus on reflection.
New assessments of Entrustable Professional Activities (EPAs) to be developed and piloted.
Mapping to the Generic Professional Capabilities (GPCs) and key capabilities.
The assessments we use aren’t changing at this stage, although the way trainees use the assessment tools will be slightly different as they focus them more around those Learning Outcomes and what they learnt from the assessment. When a trainee adds a new assessment event to their portfolio, they’ll be asked to select which Learning Outcome it relates to. They can also link it to a key capability or illustration if they wish.
At the back of each syllabus document, you’ll find a grid where all key capabilities have been mapped to suggested assessment types, so if a trainee is unsure how to demonstrate a particular capability, this will be a useful guide.
In the future we will be piloting some new assessments focused around broader areas of capability that are known as Entrustable Professional Activities, but these aren’t being introduced at this point.

19. Progress and ePortfolio: Creating assessments
Then this screen will open up ready for you to enter the information about your assessment.

20. Completing assessments
Indicators advise which domains assessments relate to e.g. Case Based Discussion.
You must select a domain and Learning Outcome for each assessment.
Key capabilities should be covered across a range of assessments.
Every assessment needs to be tagged to a Learning Outcome. You don’t need to tag to a key capability or illustration if it’s not relevant, but don’t forget all key capabilities will need to be evidenced, normally across a range of assessments, so make sure you tag to a key capability if it is relevant.

21. Completing assessments
Select the main domain the assessment relates to…
Start by selecting the relevant curriculum domain from the list provided.

22. Completing assessments
…and then the Learning Outcome for the relevant level.
Once you’ve selected a domain, you’ll see the Learning Outcomes for that domain appear underneath the list of domains, and you need to select the training level your assessment is at. This will normally be your own training level, so for example as an ST1-3 it would be Level 1. If you’ve agreed with your supervisor that you’ve completed a particular Learning Outcome early (for example if you’re particularly strong at communication, or leadership), then you can start to record evidence against the next level up for that particular area, before you’ve completed every single Learning Outcome at your own level.

23. Completing assessments
The key capabilities related to that Learning Outcome will be listed, so you can select these where appropriate.
If the evidence relates to one of the key capabilities for that Learning Outcome, you can easily tick these as well.
You might want to link the evidence to an illustration for that Outcome, for example if there was a particular one that you’d agreed with your Supervisor that you wanted to focus on as part of your development. To do this, just put a key word into the search box at the bottom of the assessment screen, and it will bring up all illustrations with that word in, so you can select the one you want.
Trainees will be able to tag to more than one Outcome, but we may limit how many to make sure the evidence is focused on what you have learnt or hoped to achieve.
Reflective notes can be tagged to the curriculum in the same way, if you want to link them to a Learning Outcome. There will be a wider range of reflective tools available reflecting that you may want to reflect on a variety of different situations, not just serious cases.
You can also select illustrations by putting a key term in the tagging ‘search’ box, if this is relevant.

24. Preparing for transition
RCPCH Progress goes live for all trainees in August 2018.
Resources and guidance are provided for trainees, supervisors, tutors and ARCP panels at
Levels already completed do not need to be evidenced again.
RCPCH has mapped the old to the new curriculum. Using this, existing evidence in ePortfolio will be ‘re-filed’ under one of the new Learning Outcomes when Progress goes live.
Use new case notes to record any evidence you may want to use for RCPCH Progress but that doesn’t easily tag to the current curriculum.
All trainees, except those in their final year of training, will be moved to the new RCPCH Progress curriculum in August 2018, so it’s important trainees and trainers start to familiarise themselves with the new curriculum now in preparation for the transition. The curriculum, syllabi and lots of supporting resources including transition guidance can be found on the RCPCH Progress webpage.
Level 2 and 3 trainees do not need to go back and re-evidence levels they’ve already completed.
The College has mapped every competency in the current curriculum to one of the Learning Outcomes in the new curriculum, and will be moving any evidence tagged to the old curriculum is moved to sit under the Outcome we think it’s most likely to relate to in the new curriculum. If a trainee wants to move it to a different Learning Outcome, it’s easy for them to do so.
Trainees may want to start saving some evidence this year that doesn’t easily tag to the current competences but will be useful for demonstrating how they’ve met Learning Outcomes in the new curriculum, for example in domains like professional values and behaviours, research, or quality improvement, which aren’t as explicit in the current curriculum. To do this, you can use one of the new ‘case notes’ (there are now a range of these, not just for ‘serious cases’) to store the evidence in draft.

25. After implementation
Check if you are happy which Learning Outcome/Key Capability evidence has been linked to. You can move it if you feel it better demonstrates a different aspect of the curriculum.
Consider what evidence you have for Learning Outcomes that weren’t so explicit in the old curriculum, for example evidence from your reflective notes/development log.
Discuss with your Educational Supervisor how you plan to meet the Learning Outcomes by the end of your training level. Remember the illustrations are there as suggestions to help you.
Although the College will move any tagged evidence to one of the new Learning Outcomes, trainees will need to check that they have been moved to where you feel it is more useful or appropriate. It’s quick and easy to re-assign it to a different Learning Outcome or Key Capability if you need to.
Most of the capabilities in the current curriculum map to the professional skills and knowledge Learning Outcomes, so you will need to consider what other evidence you might have that helps demonstrate domains that weren’t so explicit in the old curriculum. This is why it may be useful to start saving these in case notes or your development log before the transition, so they are easy to add in after the new curriculum goes live. Remember that the key capabilities for each outcome need to be explicitly demonstrated, but there are also lots of illustrative examples in the syllabus documents of other evidence that may help trainees fully meet the requirements of the Learning Outcome.
At the first supervision meeting after transition, trainees and their Educational Supervisors should discuss how they are performing against each Learning Outcome, and how they plan to meet any development needs before the end of their training level so that all outcomes are achieved.

26. Return to work checklist
Enclosed in your packs and on LSP website
Useful to complete together with educational supervisor at induction meeting and scan into e-portfolio
Covers:
Your confidence and skills level
Ways in which you could be effectively supported e.g. initial supervision for preterm deliveries / intubation
Changes in practice / guidelines you should be aware of
Any ongoing health issues

27. Useful resources /courses
LondonPaediatrics website
Compass
Transition to Leadership
Transition to Consultant
START evening
LME evenings

29. LTFT training
PREPARATION FOR RETURN TO ACUTE CLINICAL PRACTICE

30. LTFT Training Programme – why is there one?
Aims To retain within the medical workforce doctors who are unable to continue their training on a full-time basis To promote career development and work/life balance for doctors training within the NHS To ensure continued training in programmes on a time equivalence (pro-rata) basis To maintain a balance between less than full-time arrangements, educational requirements and service needs.

31. LTFT Training – Who is eligible?
All doctors in training can apply for flexible training
Every application will be treated positively
It is expected that those with Category 1 reasons for training flexibly will be accommodated
All efforts will be made to provide flexible training for those applicants with reasons in Category 2

32. LTFT Training Category 1 Category 2
Disabled or in ill-health (including IVF)
Caring for an ill/disabled partner, relative or other dependent
Providing care for young children (both male and female applicants)
Opportunities for personal development e.g. participation in national sporting events
Medicolegal politics, committee involvement or journalism
Religious commitments
Non-medical and professional development e.g. management courses

33. LTFT Training - Options
Post
Details
Advantages
Disadvantages
Slot – Share (Preferred option)
2 trainees share a single full-time slot on a rota.
Each must work at least 50% but they can work different percentages of the full time week.
Gives exposure to out-of-hours and on-call work.
Trainees can split the rota as per their needs.
Flexibility – trainees can choose when to overlap (if working >50%)
Need to be allocated a slot-share partner who can work the appropriate days of the week.
Needs very good communication between partners to ensure adequate handover of jobs/patients.
May miss activities which occur on the days not worked
Reduced hours in a full time post
A trainee works a certain percentage of hours. The trust/ department has to cover the remaining shifts. Usually the trainee needs to work 70% or more but this method of working may be used for <70% if a slot-share cannot be arranged.
Trainee can usually choose the shifts as per their needs.
May need to do more on-calls/ night shifts than a slot-share to cover the service.
Difficulties with attitudes of colleagues if remaining shifts have to be covered (or if locums cannot be found.)
Supernumerary
A trainee may be either an “extra” doctor on the rota working alongside a colleague or an additional post on the rota may be created for them. On-calls and night shifts are not included and need to be arranged by separate negotiation with the trust.
Shifts can be arranged to suit the trainee.
Colleagues usually appreciative of extra help.
Majority of work hours are 9-5.
Can be difficult to arrange out-of-hours banding/ salary with the trust.
Possible reduced exposure to out of hours training experience
Posts not educationally approved without out-of-hours experience and need separate assessment of educational value of the post – more paperwork to complete.
Can be difficult to integrate with the department – not “part of the team.”
SLOT SHARE
Reduced hours in a full time post
Supernumerary

34. How do I apply? one online form Apply once to train LTFT
Only need to complete new form if changing pattern of work
TPDs/med staffing/finance no longer needed to sign form
Trainee support portal

35. How do I apply?

36. Tips from previous LTFTs
Make friends with your job share partner!
Be fair and systematic in the way you split up on-calls
Consider your training needs when deciding which days of the week to request working
Don’t always work the same days every rotation – there are benefits to different working patterns
Keep a note of the shifts/times you work – to ensure you are being paid correctly
Out-of-office is your friend!

37. Pay 2016 contract pay protection LTFT pay:
Below ST3 – section 1 pay protection (cash floor)
Above ST3 – section 2 pay protection – as per 2002 contract for 4 years or up to August 2022 whichever is sooner
LTFT pay:
2002 contract: broad bands (hrs worked e.g. F6) + banding supplement (pattern of work FA/B/C) as per MN37
2016 contract: same system as full timers but on a pro-rata basis
Annual leave, bank holidays and study leave are all calculated pro-rata
Study leave budget allocated at the discretion of your local Trust

38. Pay

39. Pay
Pay is calculated based on your total hours and out-of-hours banding
Annual leave, bank holidays and study leave are all calculated pro-rata
Study leave budget allocated at the discretion of your local Trust

40. Pay

41. LTFT – Take Home Messages
All trainees are entitled to apply for LTFT You need 3 months notice Once in post, refer to RCPCH / BMA / NHS employers to check you are getting the correct pay and leave entitlements