FAQs on Workplace Based Assessment

Q. How does the College ensure the curriculum is interpreted in similar ways across deaneries? For example, ’Community orientation‘ rarely seems to be given the meaning set out in the Learning and Teaching Guide.

A. The key to this is clear specification of what is required.  The 12 competency areas of WPBA are derived from the core curriculum statement: Being a General Practitioner. The competency areas within WPBA are defined in terms of a scoping statement and a series of developmental descriptors.  These are laid out in the eportfolio.   

Uniformity of interpretation depends on a shared understanding between trainers, educational supervisors and trainees. This in turn is dependent on training and calibration which will be provided by deaneries.

Q. Is experience in Out of Hours (OOH) services required?

A. Yes. However, competence in OOH is not assessed within the WPBA framework. The trainee will need to demonstrate competence in OOH care as per the existing arrangements within deaneries. The progress towards and achievement of competence will be logged within the trainee’s eportfolio.

Q. What is the format of the six-monthly staging reviews?

A.  Approximately every six months, the GP educational supervisor and trainee meet to review all the evidence collected in the trainee’s portfolio up until that point. The trainee will conduct a self-assessment, and his/her progress against each of the twelve competency areas will be judged by the educational supervisor.  A learning plan will then be agreed. All this information will be recorded in a standardised format in the eportfolio.  It is anticipated that such a review is likely to take somewhere between 1 to 2 hours.

Q. Should appraisals be incorporated into the review process in some way; do registrars need evidence of competence in appraisals? Will the GMC lay down requirements for trainee appraisal?

A. The staging 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 do if they had concerns with a GPStR at the 6 monthly review and the Deanery Panel was not due to meet for another 6 months?

A. The educational supervisor would follow the current Deanery arrangements relating to concerns. Clearly, progress against the 12 WPBA competency areas will be noted, but if the concerns are serious or need immediate attention, then contact will need to be established with the Deanery.

Q. Where will adverse events and audits be recorded? Is there guidance on how these should be approached?

A. Demonstration of competence in competency area 10 explicitly requires the trainee to provide evidence in the areas of SEA and audit. Although the need to write a structured report as per existing summative assessment requirements has been removed, the trainee will still need to demonstrate competence in these areas by participating in an audit and engaging in significant event processes. It will be up to the educational supervisor to assess competence in these areas through reviewing the evidence presented by the trainee at the regular reviews.

Q. Does the RCGP have any role in quality assurance of WPBA?

A. Yes it does. The RCGP will be responsible for national quality monitoring of WPBA. At deanery level, RCGP representation will be required in the deanery panels that review all trainee portfolios.

Q. What is the College doing about finding representatives for deanery panels?

A. The RCGP will be recruiting college assessors against a person specification and  training them for the role.

Q. Who or what is the educational supervisor – what skills are needed?

A. The RCGP believes that educational supervision will be best provided from general practice over the entire training period. The exact arrangements will need to be defined by individual Deaneries.

It is anticipated that educational supervision arrangements will be orchestrated by Deanery programme directors. The actual supervisor for a given trainee may be a programme director or a GP trainer. The aspiration is that the educational supervisor is responsible for the entire training envelope for a given trainee.

Q. How does WPBA fit in with the Gold Guide?

A. The WPBA arrangements in relation to educational supervision, and annual review of trainee progress are set out in the Gold Guide to Specialty Training.

Q. What happens if a trainee fails a placement?

A. Failure in this context is not an appropriate term. Trainees may have significant developmental needs identified during a placement. These will be delineated using the specified RCGP assessment tools or recorded separately by the clinical supervisor during an attachment using the clinical supervisor’s report (CSR). This information will feed into the relevant staging review, and at the direction of the educational supervisor to the annual deanery process, where the panel will decide if the trainee needs any additional training.

Serious issues of professional performance or ill health during a placement will need to be handled by normal acute trust/ PCT/ deanery mechanisms.

Questions relating to the evidence gathering tools

1. CbD/COT

Q. Should trainers be planning to cover most of the competence areas in each CbD, or just a couple per case?

A. As many competencies that are relevant to the case and allowable within the time-frame should be covered. It is unrealistic to expect that all the CbD competencies will be covered in a single case discussion. For this reason it is recommended that the trainee has several CbD discussions during their training to ensure sufficient sampling of all the competencies. This is analogous to the current MRCGP video assessment.

Q. Is there any guidance on the amount of time a single CbD should take?

A. Yes the guidance notes on CbD state approximately 30mins for each case discussion to include the discussion itself, completing the rating form and giving the trainee feedback.

Q. Should there be calibration of CbDs/COTs at scheme or deanery level or is this not necessary?

A. This is not necessary, as these tools simply serve to gather information which is reviewed at the staging reviews. Although each CbD is pushing the trainer to make judgements against the CbD competencies, the purpose of this is to elicit information that feeds into the WPBA competency areas and generates feedback to the trainee. There is no pass/fail for any individual Cbd or COT or any of the other WPBA tools.

Q. How much leading should the trainer do in their questions for CbDs?

A. The assessor is eliciting information and therefore may use any questioning style that is appropriate.

Q. Is it acceptable to use a case where there has been a debrief or is that too easy?

A. No, such a discussion would not be a CbD as set out in the CbD guidance.

Q. What sort of paperwork should the registrar produce?

A. Just the actual written notes relating to the case and consultation under discussion. Viewing this on the computer or a computerised printout is fine.

Q. One or two CbDs at any one sitting – does it matter?

A. No it depends upon the total time allocated for that CbD discussion.

Q. How much evidence of CbDs should be recorded and retained for QA purposes?

A. Just the completion of the rating form, areas for feedback and action points arising.

Q. Is the recommended number of CbD/COTs a minimum or an absolute?

A. It’s a minimum; more can be done if more information is required. This is a decision for the trainee and their clinical supervisor/trainer.

Q. Is it acceptable/desirable to involve another trainer in some of the Cbd/COTs?

A. During an attachment, yes if feasible, but this is not mandatory. During a training programme the trainee will of necessity have different assessors drawn from the different attachments he/she rotates through.

Q. What standard of competence should be used in ST1 and ST2? Is it the standard for that stage in training or the standard which the registrar should have reached at the end of training?

A. It is the standard that a trainee should have reached by the end of the training. This means that trainees in ST1 and ST2 may well have developmental needs identified by using these assessment tools. That is what the assessment system is designed to do, so that further training placements can be directed towards the developmental needs of the trainee.

2. MSF

Q. Can the registrar ask the same people to complete the second MSF or must they be quite different people? Is this feasible in small practices?

A. Yes, most practices, even small ones, could identify 5 clinical and non-clinical colleagues to complete the questionnaire

Q. What happens if people do not respond to the questionnaires?

A. Meaningful feedback is still possible if not all raters complete the questionnaire, but the more that do, the better.

Q. Should the registrar see all the feedback, including the free text, bearing in mind that this might be quite devastating, or should the registrar get only the trainers interpretation?

A. The feedback will be sent to the educational supervisor first to enable him/her to prepare feedback based on the results, but the entire feedback will be available in an un-edited form at the supervisor’s discretion.