WPBA capabilities framework with IPUs

The Workplace Based Assessment (WPBA) component of the MRCGP exam is designed to test GP trainees’ capability in 13 key areas derived from the core RCGP curriculum statement ‘Being a GP’.

Capability means having the abilities, knowledge and skills necessary for professional practice. Our framework for WPBA is made up of 13 capabilities:

1. Fitness to practise – when a doctor is aware that his or her actions, behaviour, or health, or those of others, may put patients at risk. They should take steps to protect them
2. Maintaining an ethical approach – practising ethically, with integrity and a respect for diversity 
3. Communication and consultation skills – communication with patients, and the use of recognised consultation techniques
4. Data gathering and interpretation – for clinical judgement, choice of physical examination and investigations and their interpretation
5. Clinical examination and procedural skills – competent physical examination of the patient with accurate interpretation of physical signs and the safe practice of procedural skills
6. Making a diagnosis / decisions – a conscious, structured approach to decision-making
7. Clinical management – recognition and management of common medical conditions in primary care
8. Managing medical complexity – aspects of care beyond managing straightforward problems. Including management of co-morbidity, uncertainty, risk and focusing on health rather than illness
9. Working with colleagues and in teams – working effectively with other professionals to ensure good patient care. Including sharing information with colleagues
10. Maintaining performance, learning and teaching – maintaining performance and effective CPD for oneself and others
11. Organisation, management and leadership - this is about understanding how primary care is organised within the NHS. How teams are managed and the development of clinical leadership skills 
12. Practising holistically, promoting health and safeguarding – operating in physical, psychological, socioeconomic and cultural dimensions, taking into account feelings as well as thoughts
13. Community orientation – management of the health and social care of the practice population and local community 

WPBA capabilities with IPUs: detailed descriptors (198 KB PDF)

Indicators of potential underperformance (IPUs)

The capabilities framework (CF) developed for the MRCGP from the GP curriculum, is a series of word pictures that describe ‘positive’ behaviours that doctors display in practice.

The CF has now been augmented by selectively adding a number of ‘negative’ behaviours and placing them alongside the themes in the CF to which they are particularly (but not exclusively) related. 

These behavioural descriptors are intended as an additional interpretative tool to make it easier to recognise underperformance early in training. The material may be used to give constructive feedback to the trainee.

IPU guidance (27 KB DOC)

How the WPBA capabilities are assessed

Capabilities are assessed by the full range of WPBA tools, allowing you to record multiple perspectives on your performance in the Trainee ePortfolio. It is best practice for each capability to be assessed at different times using different tools and ideally with multiple assessors. In ST3 the trainee is being assessed at the level of a General Practitioner. In ST1 and ST2 the trainee is being assessed at the level of their peers when these are done in hospital posts. During a primary care post in ST1 and ST2 the COT assessment is benchmarked against that of an independent GP.

Capability assessment through WPBA

The table below shows where you’re most likely to find evidence for each capability.

Evidence of the capabilities should reflect the breadth of the curriculum, but it’s not expected that every area of the curriculum will be covered through WPBA. Capabilities are also tested through the other components of the MRCGP exam - the Applied Knowledge Test (AKT) and Clinical Skills Assessment (CSA).

Capability assessment through naturally occurring evidence

Use the Trainee ePortfolio to record and validate informal or ‘naturally occurring’ evidence against the capability framework.

For example, you might perform an audit on a specific topic and present it at a practice meeting. This could provide evidence of several capabilities, including maintaining performance, learning and teaching and communication skills.

Your educational supervisor, trainer or clinical supervisor will create links from naturally occurring evidence to the appropriate capabilities.

Capability progression over time

Evidence of progress in the WBPA capabilities areas is gathered throughout the training programme. You’re unlikely to be able to show evidence of full capability at the start of training, but you will gradually build up evidence as time goes on.

As your Trainee ePortfolio begins to demonstrate areas of strength and developmental needs. Your trainers will adapt the learning programme to facilitate collection of new evidence.

Rating capability progression

As part of each Educational Supervisors Review (ESR), you and your educational supervisor will rate your progress on each of the 13 capabilities. Each capability is rated as one of:

• needs further development (NFD) – below expectations
• NFD – meets expectations
• NFD – above expectations
• competent for licensing
• excellent 

 WPBA capabilities and the GP curriculum

The WPBA capabilities are based on the GP curriculum (see 'Being a GP').