Reviewing the evidence

WPBA is a process of collecting evidence to build up a qualitative picture of the GPStR’s performance in training. The evidence collected in the ePortfolio will be reviewed at six monthly intervals by either the educational supervisor or the trainer (arrangements differ between deaneries) and there will be a final, holistic judgement (the final ARCP) at the end of training which will be based on a synthesis of all the evidence.

How will the reviews be carried out?

What standards should be used?

Why do we have six-monthly reviews?

FAQs

How will the reviews be carried out?

For the six monthly reviews, the GPStR will first conduct a self-assessment. Progress will be assessed by the trainer or educational supervisor against each of the twelve competence areas. Each review will be informed by the evidence collected through the WPBA tools, augmented by any naturally occurring evidence. A learning plan will then be agreed. All this information will be recorded in a standardised format in the ePortfolio. It is anticipated that the review will take somewhere between 1 and 2 hours.

The reviews provide an opportunity to consider the breadth of coverage of the curriculum as well as the specified competence areas. It maybe useful to refer to the blueprint, which demonstrates how different areas of the curriculum might be related to training experience but this should not be used as a rigid checklist

The reviews will not cover evidence of learning that is rich in knowledge, such as may arise from tutorials. However, this type of evidence will allow the GPStR and the trainer to monitor how the knowledge base of the curriculum is being covered in preparation for the AKT.

In the early stages of training it is unlikely that the GPStR will be able to provide evidence of readiness to practise. The structured evidence, considered against the competence framework will highlight the areas where the GPStR is doing well and those areas where more learning and support is needed. Thus each of the six monthly reviews will lead to a learning plan designed to enable the GPStR to collect more evidence of competence and to build up a richer picture of readiness for practice.

Toward the end of training a final review is conducted, this time without the self assessment of the GPStR. The trainer or educational supervisor will make a recommendation to the deanery regarding the overall competence of the GPStR.  This recommendation will be subject to external moderation in the deanery by an expert panel including a lay person and a representative of the RCGP.

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What standards should be used?

The standard against which the GPStR is judged is always the level of competence expected of a doctor who is certified to practise independently as a general practitioner. This standard is used throughout the three years of training. This means that in the first two years of training the GPStR is being judged against the standard they should have reached at the end of training.  Inevitably there will be less evidence from the application of the WPBA tools in the first two years of training, and more developmental needs will

be identified. This is what the assessment system is designed to do, so that further training experiences can be directed toward the developmental needs of GPStRs.

The GPStR must show competence in all twelve competence areas by the end of year 3.

Trainers are expected to use their personal experience as a GP to judge whether the evidence for each competence area and the totality of evidence indicate that the GPStR is ready for independent practice.

Why do we have six-monthly reviews?

The six monthly reviews are used to provide feedback to the GPStR on overall

progress, to identify areas where there needs to be more focused training and to identify

doctors in difficulty. These reviews must be carried out even if they do not coincide

exactly with the end of placements.  This ensures there is sufficient evidence for useful

feedback to be offered on every occasion. Doctors training flexibly are also required to

undergo reviews at six monthly intervals and must collect the same amount of evidence

for each review as full time trainees.

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FAQs

Q. Should appraisals be incorporated into the review process?

A. The six monthly reviews are educational appraisals. The evidence collection and regular review process should satisfy any modification of the NHS appraisal process.

Q. What would an educational supervisor or trainer do if they have concerns about a GPStR?

A. The educational supervisor would follow the arrangements in their deanery for reporting concerns. Educational supervisors will need to be familiar with these arrangements, particularly in respect of serious concerns which arise outside the cycle of deanery panels. Serious issues of professional performance or ill health during hospital training will need to be handled by normal trust/PCT/deanery mechanisms. 

Q. Should there be calibration of CbDs and COTs at scheme or at deanery level?

A. This is not necessary as these tools simply serve to gather information which is considered at the six monthly reviews. Although each CbD or COT is pushing the trainer to make judgements against the competences, the purpose of this is to elicit information which feeds into the overall picture of the GPStR and generates feedback to them. There is no pass or fail for CbDs and COTs or for any other separate WPBA tool.

Q. How much evidence of each competence does a GPStR need in order to complete the WPBA?

A.  Assessment of competences is about making a qualitative judgement not a quantitative one. We would expect that at the end of ST3 the GPStR will have several sets of evidence in each competence area, collected from a range of settings and through different tools. However, the only requirement is that there is enough evidence to enable the trainer to feel confident that the GPStR is competent to practise. Each portfolio will look slightly different, but it should provide a rich picture of competence built up over three years. The “ticks” in the ePortfolio are simply a way of keeping a shared, transparent and systematic record of evidence.

Q.  How do we record when a trainee is poor at his or her work, or incompetent?

A.  The process of workplace based assessment is about recording when and at what level an individual demonstrates competence. If an individual is incompetent there are often reasons related to employment or personal reasons why that may be so, and they need to be addressed through the appropriate channels. Any probity issue should of course be recorded within the ePortfolio.

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