Educational Supervisors Review (ESR)

Workplace Based Assessment (WPBA) builds up a qualitative picture of your performance in training. The evidence you collect in your Trainee ePortfolio is reviewed at six-monthly intervals by the educational supervisor.

Purpose of the Educational Supervisors Review (ESR)

ESRs provide feedback on your overall progress and identify areas where you need more focused training.

Reviews are informed by the evidence you collect through the WPBA tools, along with ‘naturally occurring evidence’ from elsewhere in the Trainee ePortfolio (for example, the Learning Log).

You’ll then agree a learning plan, and the outcome of the review will be recorded in your Trainee ePortfolio. The educational supervisor decides whether your progress is satisfactory, unsatisfactory or needs to be referred to the ARCP panel.

Towards the end of training there’s a final review, and the educational supervisor makes a recommendation to your deanery ARCP panel regarding your overall capability. The ARCP panel makes the final judgement on whether you’re competent for licensing, based on the evidence in the ESR and your Trainee ePortfolio as a whole.

Frequency of ESR

An ESR is conducted every six calendar months, whether you’re training full-time or not. Reviews are carried out even if they do not coincide exactly with the end of posts. This ensures regular feedback and engagement with the evidence in the Trainee ePortfolio, and means that the ARCP panel has a recent ESR to inform their decision making.

Review meetings usually take between one and two hours, followed by a write-up in the ePortfolio.

Capability progression in ESR

For the six-monthly reviews, you’ll first conduct a self-assessment of your progress on the 13 capabilities. You’re then be assessed by the educational supervisor.

Quality of evidence is more important than quantity. In the early stages of training, it’s unlikely that you’ll be able to provide evidence of readiness to practise. But the review will form the basis of a learning plan, highlighting where you’re doing well and where more support is needed.

By the end of ST3, the educational supervisor will be looking to establish fitness to practise through several sets of evidence in each capability area, collected from a range of settings and through different tools. Each portfolio will look slightly different, but it should provide a rich picture built up over three years.

Clinical experience groups coverage in the ESR

While it’s not the main focus of ESR, you’ll have opportunities to consider breadth of clinical experience groups coverage as well as progress in the capabilities. When reviewing your Trainee ePortfolio, you and your educational supervisor can monitor how far you’re covering the range of knowledge described in the curriculum, in preparation for the Applied Knowledge Test (AKT) and clinical practice.

Completing trainee self-rating and educational supervisor capability grading for ESR

Capability areas:

For each capability the list of linked evidence should be reviewed.

These can be opened and reviewed by clicking on them.

For each capability area the trainee is required to pick three pieces of evidence, from the range available, which most accurately gives the summary of their current performance in that capability area.

It is preferable that a range of types of evidence from logs and assessments (CbDs, CSR etc) is selected, though often logs alone may be used if these demonstrate a range of the descriptors.

Using the capability descriptors, the trainee states what these pieces of evidence show them doing and how they support the grade they have given. They should only comment on evidence within the portfolio not their opinion of anything that is not recorded.

As an ST1/2 it would be expected that they would be meeting the Needs Further Development NFD descriptors but may also have some showing competent.

  • NFD- BE (Below Expectations) - may be picked if the evidence used show poor performance or elements of the Indicators of Potential Underperformance IPUs or if the quantity or quantity of evidence is so poor that it is not possible to grade any higher.
  • NFD- ME (Meets Expectation) - may be picked if the trainee is demonstrating many of the elements of NFD in the capability descriptors, with several pieces of evidence supporting this.
  • NFD- AE (Above Expectation) - may be used if the evidence cited demonstrates some of the Competent capability descriptors and there is a good amount of good quality evidence linked.

For the pre ARCP ESR evidence from any time in that year, even if it does not appear in this review, can be cited. E.g log entry 20.3.19 DVT entry shows me using “a stepwise approach, basing further enquiries, examinations and tests on what is already known and what is later discovered” as having calculated a Wells score I did an inhouse D dimer and then referred the patient for an US scan of the leg. This is in the excellent descriptors and would be evidence of NFD-AE for a pre final ESR trainee or Competent or excellent for a ST3 completing their final ESR.

The ES or CS may have stated, in the log comments or assessments feedback, why they were linking the log to set capabilities or grading the assessment as they did and if they have done this, quoting the capability descriptors, their comments can be copy and pasted into the self-assessment. Trainees being clear in their log which of the capabilities they feel they are addressing makes this more likely and as a result commenting on evidence is much easier and quicker in the ESR.

In order to have a good range of evidence to use it is important that all of the capabilities have at least one log linked to it in the review period. More logs allow for more of the capability descriptors to be evidenced and a higher grade awarded.

It is important to demonstrate the capabilities across the range of Clinical experience groups but not all have to be demonstrated in each one. How many is possible will depend of the post under review.

Examples:

ST3 final ESR:

ST2 mid year ESR:

ST1 mid year ESR:

Action plans:

After completing the capability grading the trainee will be asked to pick up to 3 capabilities that they feel they need to focus most on developing in the next review period.

For each of these they need to write what they aim to achieve, ideally relating to the capability descriptors.

The ES may add a further two of these if the trainee has not selected a capability that they feel is important for the trainee to address.

This is required even for final review ST3/4s as they need to plan further development in their post CCT pre-appraisal period.

Examples:

ST3 example:

ST2 example:

ST1 example:

ES:

The Educational supervisor should read the trainee self-rating and review the evidence they have linked and decide if they feel that this does support the grade given. They also need to decide if this is a true representation of the trainees current level as demonstrated within the portfolio. To do this they need to be aware of or review all the linked evidence. If the trainee has clearly stated what the evidence shows and how, using the capability descriptors, they are able to justify the grade and the evidence linked supports this, the ES can simply agree, stating that they have confirmed this to be correct. If however there is evidence that they feel supports a lower grade they need to link this evidence and state why this supports a lower grade. Similarly, if they feel that the trainee level is higher than they have graded themselves they justify this different grade using linked evidence and stating how this supports this revised grade. They are able to link up to an additional 3 pieces of evidence.

Examples:

Example of agreeing with grade trainee has given:
Example of giving lower grade than trainee has given:
Example of giving higher grade than trainee has given:

PDP review:

Reviewing the PDP and helping the trainee write SMART entries is an important part of the ESR meeting and review.

Before each placement/post, as well as during it, trainees should think about what their learning needs are, relevant to that post and how to address these. For ST1s this can be done before or at their initial meeting with their ES and subsequently when completing their self-assessment review for their ESR. Trainees should propose at least one PDP entry that covers a learning need and make a SMART plan for achieving this.  At the ESR the trainer can edit this/these and also help the trainee create other relevant ones if needed.

PDPs are focusing on specific topic, skills or learning needs that the next post will require and help them achieve. They may well be about specific parts of the GP curriculum and are separate to the actions plans which focus on demonstrating progression in the capabilities.  

 

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