Indicators of Potential Underperformance

2014

Today

• What is an IPU? How can we use them?

• Does the RDMP model help?

• Educational prescriptions.

Reminder

• RCGP Curriculum Statement:

• 1. Core Statement: Being a GP

Being a GP: 12 Competencies

• Communication and consultation skills • Practising holistically • Data gathering and interpretation • Making a diagnosis and making decisions Clinical management • Managing medical complexity • Primary care administration and IMT • Community orientation • Maintaining performance, learning and teaching• Maintaining an ethical approach to practice• Fitness to practise

12 competencies: demonstrable behaviour

Eportfolio

• Word pictures: positive descriptors

• NFD, Competent and Excellent

• On CBD or ESR

Indicators of Potential Underperformance

• Aim to identify early TID

• Then offer targeted feedback and remediation

IPU

• “These go beyond the opposites and add useful meaning or emphasis to the themes that they are placed alongside”.

• Not a level below NFD eg may alter excellent to competent

IPU

• Added to word pictures on E-portfolio…

So if IPU noted – what to do?

• Discuss with trainee

• Offer feedback and suggestions

So if IPU noted – what to do?

• Is it significant:

• Recurrent?

• Noticed by others?

• Apparent in other situations/areas?

• A unifying theory of clinical practice: Relationship, Diagnostics, Management and professionalism (RDM-p). Norfolk T, Siriwardena AN. Qual Prim Care. 2009;17(1):37-47

RDM-p (2009)

• Links 12 competencies into 4 clusters

• Creates links between the competencies to help us understand the relationship between them

• Can be used diagnostically ….

RDMP (2009)

• http://www.wpba4gps.co.uk/fileadmin/user_upload/secure/mindmaps/Understanding_the_Theory/Competence_Framework/RDMp_Master/RDMp_Master-V2.pdf

What are the reasons for underperformance

• This may be beyond today but remember include • Poor training for general practice; • Lack of continuing education; • Isolation from colleagues; • Physical health problems; • Mental health problems including alcohol and drug abuse; • Stress related to work or domestic situations; • Low morale; • Excessive workload; • Poor practice infrastructure; • Poor relationships within a practice; • Poor premises and facilities; and • Poor communication and relationship with Educational Leaders.

Educational prescription?

• Do not ignore IPU

• Establish if significant

• Be aware of reasons for underperformance

• Consider how our feedback and educational planning are affected by the IPU