The Competence Framework

The competences which form the framework for WPBA are derived from the first Curriculum Statement, “Being a GP”. All trainers should have received a printed copy of this Statement through their deanery.

What are the competences which form the framework for WPBA?

How are the competences assessed?

FAQs

Resources

What are the competences which form the framework for WPBA?

The competence framework is set out below:

1. Communication and consultation skills: this competence is about communication with patients, and the use of recognised consultation techniques.

2. Practising holistically: the ability of the doctor to operate in physical, psychological, socioeconomic and cultural dimensions, taking into account feelings as well as thoughts.

3. Data gathering and interpretation: the gathering and use of data for clinical judgement, the choice of physical examination and investigations, and their interpretation.

4. Making a diagnosis / making decisions: this competence is about a conscious, structured approach to decision making.

5. Clinical management: the recognition and management of common medical conditions in primary care.

6. Managing medical complexity and promoting health: aspects of care beyond managing straightforward problems, including the management of co-morbidity, uncertainty, risk and the approach to health rather than just illness.

7. Primary care administration and IMT: the appropriate use of primary care administration systems, effective recordkeeping and information technology for the benefit of patient care.

8. Working with colleagues and in teams: working effectively with other professionals to ensure patient care, including the sharing of information with colleagues.

9. Community orientation: the management of the health and social care of the practice population and local community.

10. Maintaining performance, learning and teaching: maintaining the performance and effective continuing professional development of oneself and others.

11. Maintaining an ethical approach to practice: practising ethically with integrity and a respect for diversity.

12. Fitness to practise: the doctor's awareness of when his/her own performance, conduct or health, or that of others, might put patients at risk and the action taken to protect patients.

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How are the competences assessed?

The competences are not content base but can be evidenced in a variety of different settings during training. There will be a process of triangulation whereby competences are assessed using different tools. Evidence of the competences should reflect the breadth of the curriculum but it is not expected that every area of the curriculum will be covered through WPBA. Some areas will be tested more appropriately through other components of the nMRCGP, the Applied Knowledge Test (AKT) or the Clinical Skills Assessment (CSA). The competences are assessed through a process of multiple sampling, providing multiple perspectives on the performance of the GPStR.

Evidence in each of the competence areas is gathered in different settings during the three years of training. Most GPStRs will not be able to show evidence of competence at the beginning of their training but will gradually build up evidence as training progresses. As the evidence in the e Portfolio begins to demonstrate where there are areas of strength and where there are developmental needs, then trainers will adapt the learning programme to facilitate collection of new evidence. The picture of competence should become more rounded and complete as the GPStR moves through the training programme.

Progress through each of the competence areas can be recorded as one of the following:

(I) Insufficient evidence
From the available evidence, the doctor’s performance cannot be placed on a higher point of this developmental scale.

(N) Needs further development
Rigid adherence to taught rules or plans. Superficial grasp of unconnected facts. Unable to apply knowledge. Little situational perception or discretionary judgement.

(C) Competent
Accesses and applies coherent and appropriate chunks of knowledge. Able to see actions in terms of longer-term goals. Demonstrates conscious and deliberate planning with increased level of efficiency. Copes with crowdedness and is able to prioritise.

(E) Excellent
Intuitive and holistic grasp of situations. No longer relies on rules or maxims. Identifies underlying principles and patterns to define and solve problems. Relates recalled information to the goals of the present situation and is aware of the conditions for application of that knowledge.

The WPBA tools where evidence for each competence is most likely to be found are shown below.

The ePortfolio provides developmental descriptions (or word pictures) for each competence area and these will help to ensure trainers are making consistent judgements.

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FAQs

Q. Why are there twelve competence areas when “Being a GP” lists only six?

A.  The competences in the Curriculum Statement needed to be operationalised in a way which could be assessed. Some of the original competences needed to be sub-divided and made more specific to make it easier for trainers to identify appropriate evidence.

Q. Can you give me a definition of competence?  

A.  The PMETB defines being competent as having the requisite or adequate ability, having acquired the knowledge and skills necessary to perform those tasks which reflect the scope of professional practices. It may be different from performance which denotes what someone is actually doing in a real-life situation.

Resources

Being a GP. RCGP Curriculum Statement No.1   (link to document)

Workplace Based Assessment. A paper from the PMETB Workplace Based Assessment Subcommittee.  Jan 2005.  http://www.pmetb.org.uk/media/

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