All trainees are expected to document their learning through their learning log. The learning log is your personal learning record. It’s used to collect evidence about your progress and share it with your supervisors and ARCP panel, as part of the Workplace Based Assessment component of the MRCGP exam.
List of log types
The learning logs are grouped in a manner that mirrors your post-CCT GMC requirements:
- Reflection on reviewing what you do, and learning from cases, data and events.
- Seeking and reflecting on feedback about what you do.
- Evidence of keeping up to date (for trainees, becoming up to date across the curriculum) – Continuous Professional Development (CPD).
For most log entries you will suggest linkage to the relevant Clinical Experience Groups and Capabilities, providing justification of the Capabilities chosen in certain logs. The GMC requires you to demonstrate reflective practice, which is core to your professionalism and learning and this will be done through your learning logs.
How many log entries are required?
You are required to write THREE Clinical Case Reviews per month on average (pro rata for those who are Less Than Full Time (LTFT)).
You are also required to arrange and write up a placement-planning meeting at the start of each new post.
You are expected to have more than one log entry which addresses each Capability in each 6-month review period. You will therefore need to complete learning log entries in addition to Clinical Case Reviews, which reflect on your experiences in such a way that they are appropriately linked to Capabilities such as Organisation, management and leadership, Ethics, and Fitness to Practice. Learning logs looking at leadership, quality improvement and prescribing activities, for example, will be very important in achieving these links.
Outline of log types
I. Reflection on reviewing what you do, and learning from cases, data and events
Clinical Case Reviews
These should account for more entries than other learning logs and provide the best opportunities for linkage to the Capabilities and Clinical Experience Groups. Entries previously described as Clinical Encounters and Professional Conversations will be mapped to this new entry. The clinical learning from acute, chronic, emergency or unscheduled care experiences is recorded here. There is now the option within the Clinical Case Review to document learning in a variety of settings (both in and out of standard GP hours) in addition to the type of consultation. You are expected, after a brief description of the case, to reflect on what you need to maintain, improve, or stop doing. Before considering this, it is recommended that you reflect on what went well and why, so that you can maintain these behaviours. This reflection should include actions required in response to your emotional needs as well as clinical and educational actions i.e. ‘how did it make you feel?’
The option for the supervisor to comment on the entry is retained. The supervisor is encouraged to comment on each capability linked. Whenever the supervisor disagrees with a suggested Capability or Clinical Experience Group link their explanation should appear in the comments section.
When new learning or experiences present themselves, these should be documented in your log. It is particularly important to document learning in Unscheduled Urgent Care/ OOH care within your Clinical Case Reviews, as this will provide evidence of your understanding of working in this setting. It is not mandatory that you complete a Clinical Case Review for each Unscheduled / OOH care session undertaken but documentation of any attendance in this setting should be entered in the ‘supporting documentation’ section of the log.
Clinical Examination and Procedural Skills - CEPS
The CEPS entry format is unchanged. Evidence of your ability to perform a variety of examination and procedural skills in order to demonstrate this Capability (including the mandatory skills) remains essential.
Placement Planning Meetings
This allows for a record of placement planning meetings which are now mandatory. It links in particular to Working with colleagues and in teams, Fitness to practice, and Organisation, management and learning.
Quality Improvement Activity - QIA
This reflective learning log entry enables QIA to be captured across the full training programme. At present, the GMC and RCGP are promoting quality improvement activity projects, which use a different methodology to audit. (Previous Audit/Project entries will be mapped to this area). The quality improvement activity should be robust, systematic and relevant to your work. The QIA reflection should include an element of evaluation and action, and where possible, demonstrate an outcome or change.
The GMC recommend that all doctors demonstrate involvement in Quality Improvement at least once a year. This mirrors the broad definition for post-CCT doctors and ensures that you are equipped with appropriate quality improvement methods for lifelong competence. Please see the WPBA website pages for further guidance on QIA suggestions.
The QIA should be completed electronically in the portfolio.
For detailed information, please see the QIA section.
Please note Quality Improvement Project (QIP) is a separate form. You can read more about this form here.
Prescribing
This assessment has been created because of the importance attached to prescribing by the GMC. You will complete this assessment and reflective entry in ST3. It follows a formal process where you will reflect on your prescribing of 50 consecutive prescriptions in relation to safety and appropriateness. See the section on prescribing assessment for more information.
Learning Event Analysis (LEA) and Significant Events
The analysis of events which do not reach the GMC threshold for harm but present an opportunity for learning are referred to as Learning Events Analysis and need to be documented annually on this form. This might include events which may not have a serious outcome but highlight issues which could have been handled with greater clinical effectiveness and from which lessons can be learnt.
An entry under Learning Event Analysis would normally involve sharing information within the team and demonstrating learning. Areas for further learning and development should be reflected in your Personal Development Plan (PDP).
Significant Events must be reflected on, and the new format allows clarification of which events have been identified as being in this category through having an additional drop-down box.
Leadership, Management and Professionalism
A new reflective log entry in relation to leadership, management and service delivery changes, has been created to ensure you have the opportunity to reflect on your experiences of the identified leadership qualities within a non-clinical log entry. Learning about leadership skills is an important area of GP training. The non-clinical work a GP is required to do is complex within an increasingly diverse clinical workforce. This new log entry enables appropriate documentation of experiences and reflection. You are encouraged to record activities such as chairing a meeting, giving a presentation, or a ‘Fresh Pair of Eyes’ exercise. The NHS Leadership Academy suggests leadership in the health and care services is about delivering high quality services to patients by: demonstrating personal qualities, working with others, managing services, improving services, setting direction, creating the vision, and delivering the strategy. ‘Delivering the Service’ is at the core of this leadership model.
Academic Activities
The Academic Activity log remains unchanged and is designed to be used by trainees in an academic post.
II. Seeking and reflecting on feedback about what you do
Reflection on Feedback
A new reflective log entry enables you to reflect on the following feedback: colleagues (MSF), patients (PSQ) and leadership (leadership MSF), in addition to reflections on the ESR, CSR, Educator notes, examination results for example.
III. Evidence of keeping up to date – Continuous Professional Development (CPD)
Supporting Documentation (Continuous Professional Development (CPD) evidence)
This new area allows you to record and reflect on relevant pieces of evidence that you may have highlighted from your clinical reviews or PDP. It also allows you to provide evidence and share brief summative reflections of your CPD evidence of reading / reflections on learning events. By separating this from the reflections on clinical work we are supporting a degree of separation between WPBA and the appraisal functions of the GP trainee Portfolio. Basic life support, safeguarding certification, Unscheduled / Out of Hours attendance should be appropriately recorded here.
Other learning such as eLearning, tutorials, courses/certificates, lectures and reading can appropriately be recorded in the CPD area. Trainees may want to note that entries which are purely documentation of reading or of doing an online course are not Workplace Based Learning Activities
Unscheduled urgent care (UUC) / Out of Hours (OOH)
All trainees need to get experience in UUC/ OOH and evidence of your attendance at these sessions needs to be included in your supporting documentation section.
Some areas of the UK expect the number of hours/sessions undertaken in the UUC / OOH setting to be documented as part of your GP trainee contract. In this case a summary table should be completed and uploaded as a separate ‘supporting documentation’ entry before your final ARCP.
Examples of different types of learning logs