Promoting Excellence in Family Medicine

Workplace Based Assessment

Dr Jane Mamelok

RCGP WPBA Lead

Associate Director GP Education

Workplace Based Assessment

“The evaluation of a doctor’s progress over time, in their performance in those areas of professional practice best tested in the workplace”

The new MRCGP Tripos

Workplace based assessment (WPBA)

Machine marked test of applied knowledge (AKT)

Clinical Skills Assessment (CSA)

nMRCGP Integrated assessment package

AKT – knowledge – >3 /12 ST3CSA - CLINICAL skills > 6/12 ST3The WPBA – tests those competencies not addressed in other components – 3 years.

WPBA – attitudes, team work, assessment of performance and competence in practice, needs to include audit, consultation skills, management, peer review and appraisal.

Miller’s Pyramid

KnowsKnowledg

eAKT

Shows How

Knows How

Performance

Competence

CSA

CSA

DoesActionWPB

A

Where do the competencies come from?

Domains of GP Curriculum

EURACT (European Academy of Teachers in General Practice)

GMC – Good Medical Practice

12 competency areas

1. Communication and consultation skills2. Practising holistically3. Data gathering and interpretation 4. Making a diagnosis / making decisions 5. Clinical management6. Managing complexity and promoting health 7. Primary care administration and IMT8. Working with colleagues and in teams9. Community orientation10. Maintaining performance, learning and teaching11. Maintaining an ethical approach to practice 12. Fitness to practise

RELATIONSHIP DIAGNOSTICS

MANAGEMENT

Professionalism

Maintaining Performance, Learning & Teaching

Primary Care Administration

& IMT

Community Orientation

Maintaining an Ethical Approach to Practice

Fitness to Practise

Data Gathering & Interpretation

Clinical Management

Managing Medical Complexity

Making a Diagnosis / Making decisions

Communication & Consulting Skills

Working with Colleagues & in Teams

Practising Holistically

Some myths about WPBA

WPBA is a continuous process, assessing the development of competencies in the workplace over the 3 year training envelope.All assessments must be timely i.e. within that 3 year envelope, FY2 competencies cannot be carried forward for WPBA (although they can link with the e-portfolio for NHS appraisal)

Some myths about WPBA

By the end of training the trainee must demonstrate competence in the 12 required areas.

Naturally occurring evidence (professional conversations, learning logs, audit etc.)

Evidence taken from WPBA assessment tools informs the deanery review process.

Some myths about WPBA

WPBA and e-portfolio are NOT synonymousWPBA is longitudinal assessment of performance in the workplace.E- portfolio is the personal learning portfolio and this houses all the required assessments including WPBA for the nMRCGP and the certification and licensing process.

There is a risk of teaching to the assessment hurdles

WPBA is not just 12 COTs & 12 CBDsMSF & PSQ give valuable information about “attitudes”The Naturally occurring evidence is the “Jewel in the crown” of WPBA.

Informal feedbackProfessional conversations that validate competencyAudits, critical events.

ARCP – Panel reviews

The GPR gathers evidence – e-portfolioPrior to panel, the Educational Supervisor (ES) reviews evidence with GPR and e-portfolio generates ES Report (ESR)Panel review ESR, collates results AKT/CSA checks successful completion WPBA.Based on all the evidence, panel make recommendation for CCT.

The Blueprint Dilemma

Passed MRCGP video but tape would have failed summative assessment.

Is it possible ?

and what do we do if it happens?Could someone pass CSA but fail in those same competency area in WPBA?

Calm, considered reflection

The solution

Each component of the tripos is mapped to the competency framework, GP Curriculum & GMP.Each cover different aspects e.g. AKT clinical, CSA communication. WPBA covers them all.Congruent assessment practices across the componentsNationally agreed guidance and concordance for assessment judgements made locally.

CalibrationWe all agree on the benchmark and do the same thing

Finally…

The process is learner led.

It is the learners responsibility to gather the evidence.

Empowers the learner.

Planning and personal organisation is key.