WPBA assessments

The following video explains the new assessments in the Trainee Portfolio.

WPBA evaluates the trainee's progress in areas of professional practice best tested in the workplace and: 

  • looks at the trainee's performance in their day to day practice to provide evidence for learning and reflection based on real experiences
  • supports and drives learning in important areas of capability with an underlying theme of patient safety
  • provides constructive feedback on areas of strength and developmental needs, identifying trainees who may be in difficulty and need more help
  • evaluates aspects of professional behaviour that are difficult to assess in the Applied Knowledge Test and Clinical Skills Assessment
  • determines fitness to progress towards completion of training.

Evidence of WPBA, as approved by the GMC, includes the completion of specific assessments and reports, the documentation of naturally occurring evidence as well as certain mandatory requirements such as Child safeguarding and Basic Life Support. More information on the requirements for WPBA can be found below.

Overview documents

Assessments

Assessment numbers from August 2020

The following table summarises the number of assessments required per training year. It should be emphasised that this is a minimum number and to achieve the Capabilities to the required standard, further assessments may be required.

Less than full time (LTFT) placements

For trainees who are less than full time the same number of assessments need to be completed per ‘training year’ (this will be longer than a calendar year). For example a trainee on a 50% less than full time rotation will take 2 years to complete a ‘training year’

WPBA numbers for each year of training 

Mini-CEX/COT
Any setting (face to face, telephone, or video)

ST1:
4

ST2:
4
ST3:
7

CBD / CAT

ST1:
4CbD

ST2:
4CbD
ST3:
5 CAT

MSF

ST1:
1 (with 10 responses)

ST2:
1 (with 10 responses)
ST3:
2 (1 MSF, 1 Leadership MSF)

CSR

ST1:
1 per post*

ST2:
1 per post*
ST3:
1 per post*

PSQ

ST1:
0

ST2:
0
ST3:
1

CEPS

ST1:
Ongoing

ST2:
Ongoing
ST3:
Across 3 years
5 intimate plus a range of others

Learning logs

ST1:
36 Case reviews

ST2:
36 Case reviews
ST3:
36 Case reviews

Placement planning meeting

ST1:
1 per post

ST2:
1 per post
ST3:
1 per post

QIP

ST1:
1 (in GP)

ST2:
1 (in GP) – if not done in ST1

ST3:
0

Quality improvement activity

ST1:
All trainees must demonstrate involvement in Quality Improvement at least once a year
ST2:
All trainees must demonstrate involvement in Quality Improvement at least once a year
ST3:
All trainees must demonstrate involvement in Quality Improvement at least once a year

Significant event

ST1:
Only completed if reaches GMC threshold of potential or actual serious harm to patients.
ST2:
Only completed if reaches GMC threshold of potential or actual serious harm to patients.
ST3:
Only completed if reaches GMC threshold of potential or actual serious harm to patients.

Learning Event Analysis (LEA)

ST1:
1
ST2:
1
ST3:
1

Prescribing review

ST1:
0
ST2:
0
ST3:
1

Leadership

ST1:
0
ST2:
0
ST3:
1

Interim ESR

ST1:
1**
ST2:
1**
ST3:
1**

ESR

ST1:
1
ST2:
1
ST3:
1

CPR & AED Use (BLS)

ST1:
Competence in CPR and AED use for all placements
ST2:
Competence in CPR and AED use for all placements
ST3:
Competence in CPR and AED use for all placements

Child and Adult Safeguarding

ST1:
Knowledge and Reflection***
ST2:
Knowledge and Reflection***
ST3:
Knowledge and Reflection***

*CSR to be completed in a primary care post if any of the following apply: The clinical supervisor in practice is a different person from the educational supervisor. The evidence in the ePortfolio does not give a full enough picture of the trainee and information in the CSR would provide this missing information, and either the trainee or supervisor feel it is appropriate.

** The interim ESR review can be completed at the mid point of each year only if the trainee is progressing satisfactorily. If there are any concerns about the trainees performance or they have had an unsatisfactory outcome in their previous ARCP then the full ESR will be required.

***If a trainee does not have a placement within a specific training year that includes children, then it is not mandatory (but still recommended) to record and document their learning on Child safeguarding. 

Trainees remaining on the “old” programme of WPBA prior to August 2020 should consult those minimum requirements.

Page last updated: 6 May 2021 (added LTFT information)

Case-Based Discussion (CbD)

The CbD is a structured oral interview designed to assess your professional judgment in a clinical case. The assessment assesses your performance against the Capabilities and looks at how you made holistic, balanced and justifiable decisions in relation to patient care. It assesses your understanding and application of medical knowledge, ethical frameworks, ability to prioritise and how you recognised and approached the complexity and uncertainty of the consultation.

How to complete a CbD

CbDs can be carried out in hospital by Clinical Supervisors (which is best practice), by doctors who are ST4 or above, or Specialist and Associate Specialist (SAS) doctors with equivalent experience who have met the GMC assessor requirements. You choose who undertakes your CbDs. You are encouraged to complete assessments with a range of assessors. Your named Clinical Supervisor should complete at least one CbD during each rotation. Within primary care placements in ST1/2, your assessors will be approved GP Clinical/Educational Supervisors who have met the GMC standards.

Protected time is needed for the assessment.

The case should be one that you have managed independently. It is NOT appropriate to have received advice from another doctor for the consultation and then to be assessed on actions taken by that other doctor. 

You need to share the clinical entry with your supervisor before the assessment so they can familiarise themselves with the case.

Before the assessment you will need to map the case to up to three Capability areas as you will be discussing these areas during the assessment. It is these Capabilities your supervisor will grade. The Capabilities should not necessarily be those that you covered well, as more useful learning can be achieved by choosing areas that you found challenging. You also need to be aware of the Capabilities you have chosen in previous assessments to ensure you cover the range of Capabilities during your training.

Your supervisor can support you in case and Capability selection if you are unsure how to do this.

The RCGP has produced questions to support assessors in assessing the Capabilities and it would be useful for you have a look at these prior to your assessment. 

The CbD discussion should normally take no longer than 30 minutes for your discussion and your supervisor’s feedback. During the discussion, if your supervisor feels any other Capabilities have been covered, these can be added to the assessment form. 

Your supervisor will then complete the assessment form within your Portfolio. Each of the discussed Capability areas will be graded. Your supervisor will document their feedback on your performance and their justification for their grades as well as their recommendations for further development.

Some assessors will have full access to your Portfolio but in non-primary care settings you may need to send them a ticket code to enable the assessment form to be completed.
In this situation, having ideally agreed a mutually appropriate time to complete an assessment, it is preferable to send the ticket code in advance to your assessor.

To use the ticketed feedback system you need to click on ‘generate a new ticket’ within the Portfolio after which the ‘generate a new ticket’ page will appear. You select the ‘CbD assessment form’ and complete your assessor’s details. An email will then be sent providing a login code for the assessor to use to complete the ticketed CbD assessment form.

Download the form

Question generators

Case-Based Discussion (CbD) - FAQs

What is a CbD?

CbD stands for case based discussion. These are structured interviews that you have with your Educational Supervisor (ES). They are designed to explore the professional judgements you have made in clinical cases. You select the case you want to discuss with your assessor and prepare the case against 3 or 4 relevant capability areas.

How many CbDs am I required to do?

As an ST1/2 it is expected that you would only do CbDs. Trainees are expected to complete four CbDs in each training year (2 in each 6-month period for a full time trainee).

Do all the capabilities have to be graded in at least one CbD?

Ideally the CbDs will cover the full range of the capabilities providing triangulation of grades for each capability across a of range of different assessment methods. It is expected that all capabilities will have been assessed using a formal assessment tool at least once in the three-year training period but not all need to be done within a CbD. You will have, prior to the CbD, prepared up to 3 capability areas you wish to discuss with your supervisor.

Do I need to do a CbD for each of the Clinical Experience Groups?

It is expected that the CbDs will cover the range of Clinical Experience Groups. While it is not mandatory to have a CbD for each Clinical Experience Group, a range of types of assessment and information will need to be provided in the Portfolio to show exposure to, learning from, and competence in caring for, the range of Clinical Experience Groups across each training year. All Clinical Experience Groups should be covered by the range of assessments completed.

Is the number of CbDs required reduced for less than full time trainees?

The numbers required are prorata for less than full time trainees.

How many capabilities and Clinical Experience Groups can be linked to each CbD?

It is expected that a maximum of 3 capabilities and 2 Clinical Experience Groups be linked to each CbD so that in-depth reflection and meaningful feedback is given for each. Separate assessments can be used if the assessment covers a larger number of either.

Can all the CbDs in ST1 and ST2 be done in one tutorial?

No. it is expected that the assessments will be spread over time to demonstrate that you are progressing. The number of assessments stated are a minimum and if you are not demonstrating the grade expected for your level of training, additional assessments should be completed.

How long will it take to complete a CbD?

This will depend on the complexity of the case. A CbD usually takes between 20-30 minutes. The time for each assessment will depend on the content and the discussion you have with your supervisor.

Do I have to give my assessor details of the case in advance?

Yes. You can only be assessed on the case if you have prepared the case and stated which of the capabilities you feel you have demonstrated in advance of the discussion.

Can I be asked about theoretical situations rather than just the case I managed?

The assessment is about what you actually did so that your performance in the capability being reviewed can be assessed. However, for some more difficult capabilities it may be necessary to add hypothetical challenge to assess your knowledge, for example with regard to ethics or fitness to practice. The assessment is most robust when based on what you actually did in that case.

Do I need to provide cases of varying complexity?

Yes.  It is expected that you will be assessed in a range of cases that cover varying complexities. You will be asked to bring more complex cases if all those you bring are of low challenge.

Care Assessment Tool (CAT which includes CbD)

CbDs in General Practice / primary care placements are being replaced by Care Assessment Tools (CATs), which allows a greater range of information and performance to be recorded and assessed against the Capabilities. CbDs will remain in the non-primary care setting and become one type of CAT in in the primary care setting.

Below are suggested events that may be assessed as CATs, with details of the preparation required in advance, the content of the assessment, the Capabilities that may be assessed and the recording required.

A minimum of 4 CbDs will be required for both ST1 and 2, and a minimum of 5 CATs (which can include CbDs) by the end of ST3.

Suggested CAT formats

Case based discussion

The following is a brief summary of this type of CAT:

Preparation in advance:

Trainee:

  • Select a case for discussion.
  • State which Capabilities you feel you can demonstrate with the case.
  • Prepare a short summary of the case.
  • Prepare to discuss how you handled the case and how you met the Capability descriptors.

Supervisor /Trainer:

  • Review the case the trainee has suggested along with the medical notes. 
  • Check it is suitable for the Capabilities suggested and of a sufficient complexity.
  • Prepare questions to test the Capability areas and explore what the trainee actually did in that case. See CAT question generator for suggested questions.
  • Review the Capability descriptors and suggested questions to become familiar with what the trainee needs to demonstrate for the various grades.

Content:

Supervisor guidance:

  • The trainee briefly describes the case.
  • The supervisor asks which Capabilities the trainee wishes to discuss first.
  • The supervisor questions the trainee in a way that allows them to demonstrate the highest level they can, based on the Capability descriptors.
  • Questioning continues with the supervisor postponing any questions from the trainee until the feedback section.
  • Each Capability of the 3-4 to be addressed is discussed with time for the trainee to add anything else they wish.
  • Both refer to the Capability descriptors. It is good practice for both the supervisor and trainee to consider these during the discussion.
  • Once the case and Capabilities have been fully discussed the supervisor moves to the feedback section.
  • It can be helpful to get the trainee to say which grade they feel they have demonstrated and to give their own feedback first.
  • The supervisor gives feedback on what was done well and demonstrated with grade decision followed by feedback for improvement, future different cases, and Capabilities that still need to be covered.

Capability areas suggested:

All

Random case review

Preparation in advance:

None required

Content:

Supervisor guidance:

  • Select a date and surgery at random from the trainee’s appointment list and access the patient records.
  • There are many different ways to review random cases. Reviewing consecutive patients can be helpful and reviewing a whole surgery will give a picture of overall performance.
  • It can also be useful to review a random surgery looking through one particular ‘lens’ e.g. the appropriateness of the diagnosis or decision making; or understanding of the home circumstances of each patient / their support systems etc. i.e. how well the trainee assessed them holistically; or considering examinations carried out in detail; or recording (use of coding); or completion of all possible pop up tasks. 
  • Alternatively, it can be appropriate to look at only 1-2 cases chosen by the supervisor and review multiple Capabilities in more detail in these cases. 
  • Review how long the consultation took, as well as their recording of the consultation itself. These can be used to assess organisation, management and leadership
  • Review the trainee’s recording, using READ/ SNOMED codes as appropriate, observations recorded, history and other data gathering as well as clinical management, diagnosis and decisions and follow up.
  • Involvement of other doctors or team members may also be reviewed which can give information for the Capability of working with colleagues and teams.
  • How much health promotion was undertaken? Holistic care and managing medical complexity.
  • Did the trainee see a range of patient types, conditions and mix of urgent and unscheduled care and routine appointments? Are there actions that need to be planned in response to the balance of their work across clinical experience groups and medical specialities? 

Capability areas suggested:

All areas may be possible depending on the detail of recording.

Recording in the Portfolio:

Supervisor guidance:

  • Pick the Capabilities demonstrated and give specific case detail to justify the grading given, relating this to the Capability descriptors.
  • Give specific feedback for each Capability with agreed plans for each.

Leadership activity

The description of how to do a leadership activity is shared in this document. 

Prescribing assessment follow up

This is a follow up to the full prescribing assessment and should focus on the areas for development detailed in the prescribing assessment and how you (the trainee) have progressed with these. This may involve finding and analysing prescriptions done for specific Clinical Experience Groups, for example, children, end of life, controlled drugs use, advice re over the counter (OTC) medications, particular specialty drugs e.g. for COPD, or contraception. The Prescribing Assessment is covered later in this document. 

Preparation in advance:

Trainee:

  • You review your prescribing assessment and agreed actions. In particular you need to ensure that any of the prescribing proficiencies which you did not cover in your assessment have now been met
  • You will need to upload any further results in the Portfolio learning log.
  • You will need to reflect on your performance against the prescribing competences. 
  • Your supervisor will review your evidence and discuss this with you.

Supervisor guidance:

  • Review and discuss the trainee’s further evidence in the Portfolio and evidence from random case reviews and debriefs.
  • Review the prescribing assessment action plan and PDP entry progress.
  • Discuss areas done well and areas for improvement.
  • Together agree plans for further improving the trainee’s prescribing or increasing their exposure to patient groups to meet the prescribing competences.
  • Discuss how this has provided evidence for the prescribing competences as described in the feedback and recommendations.
  • Discuss hypothetical situations where issues have not been not covered such as prescribing unlicensed drugs, drug interactions, over the counter (OTC) medication, allergies and monitoring requirements.

Capability areas suggested:

  • Clinical management. Has the trainee prescribed safely? Are they aware of and are they applying local and national guidelines including drug and non-drug therapies? Are they aware of legal frameworks for appropriate prescribing?
  • Managing medical complexity. Has the trainee simultaneously managed patients’ health problems, both acute and chronic (e.g. by taking into account comorbidities, existing medication and allergies), communicated risk effectively to patients (from documentation in the clinical records), recognised the inevitable conflicts that arise when managing patients with multiple problems and taken steps to address these.
  • Organisation, management and leadership. Has the trainee produced records that are succinct, comprehensive, appropriately coded and understandable?
  • Community orientation. Has the trainee demonstrated how they have adapted their own clinical practice to take into account their local resources, for example colleagues with GPSPI experience; or in cost-effective prescribing by following local protocols?
  • Maintaining performance Learning and teaching. Has the trainee shown a commitment to professional development through reflection on performance and the identification of personal learning needs? 
  • Fitness to practice. Has the trainee reflected on and learnt from performance issues (e.g. drug errors) in order to improve patient care?

Recording in the Portfolio:

Supervisor guidance:

  • the supervisor completes a prescribing assessment CAT detailing the Capabilities covered and record for each:
    • Specific feedback on performance
    • Recommendations for further development

Referrals review

Preparation in advance:

Trainee:

  • Gather together either a list of all your referrals or copies of the referral letters to review.
  • Ensure sufficient time has elapsed to get letters back from the clinic visit following the patient appointment.

Supervisor guidance:

  • Look through the letters the trainee has written encouraging the trainee to critique their work.
  • Discuss the content commenting on what is good and what could be improved.
  • Is there evidence in the referral letters of appropriate data gathering, clinical examinations and procedural skills, clinical management and diagnosis and decisions?
  • Look at the correspondence received following the referral and subsequent GP consultations. 
  • Comment on the quality of the trainee’s records.
  • Discuss the appropriateness and effectiveness of the referral. What other options were available?
  • What does the trainee feel, in retrospect, about each referral?
  • What feedback would you give the trainee in general about their referrals?
  • Were any 2 week wait referrals in line with current guidance?
  • What percentage of 2 week wait referrals resulted in a diagnosis of cancer?
  • Review the appropriateness in particular of these referrals checking for any delays but also commenting on examples of good patient care. 
  • Has the referral review demonstrated that the trainee is being exposed to the full range of patients groups in general practice and a broad range of curriculum types?
  • How might the trainee develop experience in populations or specialties in which there does not appear to have been sufficient exposure?

Capability areas suggested:

  • Select the Capability areas the trainee has demonstrated during this discussion.
  • Give feedback on what they did well and what they should work on to improve or demonstrate in future learning events

Recording in the Portfolio:

Supervisor guidance:
  • Describe for each Capability how the trainee performed using the Capability descriptors and specific aspects of the cases discussed.
  • Describe the agreed actions discussed.

Download the form

Documents

Care Assessment Tools (CATs) - FAQs

What is a CAT?

 A CAT is a Care Assessment Tool. It is a workplace-based assessment that is used to record a trainee’s ability in any of the capabilities, and can be any one of a variety of different types of assessment tools including the Case Based Discussion (CbD).

How many CATS do I have to do?

In ST1/2 you will only need to do CbDs.  You are expected to complete four CbDs in each training year (a minimum of two for each 6 monthly Educational Supervisor Report (ESR)).

How is a CAT different from a CbD?

A CAT is an overarching workplace assessment term which includes CbDs. Other types of assessment can also be used to assess and record your performance in all the capabilities and are also considered to be CATs. These include problem patient discussions, random case reviews, debriefs, referral analysis and other consultation assessment tools.

Are a range of CATS needed or are single assessments sufficient e.g. all random case reviews?

In ST1 and ST2 you will only do CbDs as this is a tool that is already familiar in both primary and secondary care settings and it will ensure consistency. In ST3, however, you can complete a range of different types of CAT depending on the clinical / educational setting. There are no set numbers for each different type of CAT.

Do all the capabilities have to be graded in at least one CAT?

Ideally the CATS will cover the full range of the capabilities. This will provide a triangulation of grades for each capability across of range of different assessment methods. It is expected that you will have been assessed in all of the capabilities using a formal assessment tool at least once in your training.

Do I have to do a CAT for each of the Clinical Experience Groups?

While it is not mandatory for you to have a CAT for each Clinical Experience Group, a range of types of assessment and information will need to be provided in the Portfolio to show exposure to, learning from, and competence in caring, for the range of Clinical Experience Groups across each training year.

When I am in Primary care as an ST1 or 2, in addition to the required number of CbDs can I also complete other types of CAT?

You will need to complete the minimum number of CbDs for that post but you can also complete additional CATs. However, it should be noted that these will not replace other mandatory assessments.

How many capabilities and Clinical Experience Groups can be linked to each CAT?

It is expected that a maximum of 3 capabilities and 2 Clinical Experience Groups be linked to each CAT so that in-depth reflection and meaningful feedback is given for each. Separate assessments can be used if the assessment covers a larger number of either.

Can I do a leadership activity out with the specific examples given?

No. It is expected that the assessments will be spread out over time to demonstrate that you are progressing. The number stated are a minimum and if you are not demonstrating the grade expected for your level of training, additional assessments should be completed.

How long will it take me to complete a CAT?

This will depend on the type of assessment being completed. A referrals review may take a couple or hours. A debrief may take 15 minutes and a CbD usually takes between 20- 30 minutes. A random case review may take an hour but will depend on the number of consultations reviewed. The time for each assessment will depend on the content and the discussion that takes place.

Mini Consultation Evaluation Exercise (MiniCEX)

A MiniCEX is an observed, real-life, interaction between you and a patient. The MiniCEX assesses your clinical skills, attitudes and behaviours. The MiniCEX is completed in the non-primary care setting.

It is your responsibility to identify and approach an appropriate clinician to be an assessor. You are advised to arrange a time and date for the assessment in advance. It is recognised that on occasion, real time opportunities present themselves that are suitable for MiniCEXs. However, this should not be seen as the norm. The assessments need to be spread out across the duration of the post rather than just at the end and the assessment should not last more than fifteen minutes.

Each MiniCEX should represent a different clinical problem. It is helpful to vary the types of cases that are assessed using MiniCEXs so that your competence is reviewed with different challenges.

MiniCEXs can be carried out in hospital by your Clinical Supervisor (which is best practice), by doctors who are ST4 or above, or Speciality and Associate Specialist (SAS) doctors with equivalent experience and who have met the GMC assessor requirements. You choose who undertakes your MiniCEX. You are encouraged to complete assessments with a range of assessors. Your named Clinical Supervisor should complete at least one MiniCEX during each rotation.

Your assessor will give you immediate specific constructive feedback on this interaction, focussing on your: 

  • Professionalism
  • Communication and consultation skills
  • Clinical assessment and judgement 
  • Clinical management
  • Organisation/efficiency

The assessor will also rate your performance and document their verbal feedback on the assessment form. This feedback will subsequently be used as evidence of your progress within the Educational Supervisor Review (ESR). 

Some assessors will have full access to your Portfolio but in non-primary care settings you may need to send them a ticket code to enable the assessment form to be completed.
In this situation, having ideally agreed a mutually appropriate time to complete an assessment, it is preferable to send the ticket code in advance to the assessor.

To use the ticketed feedback system you need to click on ‘generate a new ticket’ within the Portfolio after which the ‘generate a new ticket’ page will appear. You select the ‘MiniCEX assessment form’ and complete your assessor’s details. An email will then be sent providing a login code for the assessor to use to complete the ticketed MiniCEX assessment form.

Download the form

Mini Consultation Evaluation Exercise (MiniCEX) - FAQs

Why use the MiniCEX?

It allows you to get feedback on your performance from an experienced clinician about a real patient, in real time.

Why does my clinical supervisor have to complete one WPBA (MiniCEX/CbD)?

The MiniCEX /CbD are best overseen by your clinical supervisor. This helps the clinical supervisor gain an understanding of you in terms of your clinical ability and the level of supervision required. This is valuable to help you gain the most from the rotation, but it also enables your clinical supervisor to have first-hand experience when completing their clinical supervisor report.

Can I do a MiniCEX and Case based Discussion on the same patient?

This would be discouraged. Different cases at different times should be used. The focus and set up of each assessment is different and should not be transferred.

What standard am I assessed against?

The trainee should be graded in relation to those at the same stage of training. When grading the trainee, there is the option to put ‘Not applicable’ which means that the trainee did not cover the identified area as it was not within the context of the case. This is different to ‘Significantly below expectation and/or below expectation’, which means that either the trainee did not cover the identified area to a competent level or it was not demonstrated at all, and should have been.

How many MiniCEX should I complete?

4 MiniCEXs/ COTs are required in both ST1 and ST2.

Do half of the annual number have to be done before each six-month review?

Yes.

Do I need to cover all the clinical experience groups?

Over the GP training programme, it is expected that you will submit a breadth of WPBAs relating to all the clinical experience groups.

Does it matter what level of complexity the cases I have observed are rated?

No, however it contextualises the subsequent grades. You would be expected to complete the breadth of complexities and bear in mind low complexity consultations will be unlikely to give adequate opportunity to demonstrate your ability.

Is the MiniCEX mapped to the 13 Capabilities?

Yes. The MiniCEX has been mapped to the RCGP capability statements and these are detailed below.

  1. Consultation and communication skills. Capability: Communication and consultation skills, practising holistically
  2. Clinical assessment & judgement. Capabilities: Data Gathering and interpretation, CEPS, Making a diagnosis / decisions
  3. Clinical management. Capability: Clinical management
  4. Organisation/Efficiency. Capabilities: Working with colleagues and in teams, Organisation, Management and Leadership
  5. Professionalism. Capabilities: Ethics, Fitness to practice

Capabilities not included:

  • Community orientation
  • Maintaining performance, learning and teaching
  • Managing medical complexity

Can I be awarded a satisfactory Educational Supervisor’s Report outcome if the overall rating for the last MiniCEX is ‘below expectations’?

Yes. The Educational Supervisor makes a recommendation to the ARCP panel based on all work place based assessment and the content of the Portfolio.

Do I have to have had a minimum number of scores of ‘meets expectations’ for each of the five identified areas?

No. The Educational Supervisor makes a recommendation to the ARCP panel based on all of the work place based assessment and content of the Portfolio. Progress varies from trainee to trainee. You will need to demonstrate competence by the point of CCT.

Consultation Observation Tool (COT)

The COT is an expanded version of the Mini-CEX and considers your consultations with real patients in real time during your primary care placements. It assesses the clinical skills and professionalism necessary for good clinical care within your consultations and this includes your performance of the more holistic judgments needed to consult in General Practice.

How the Consultation Observation Tool (COT) works

During training you are encouraged to video record and then review your consultations as these are an essential way of improving your consultations. The COT assessment can then be carried out using a recorded consultation; or you can arrange for your supervisor to observe you consulting directly. 

The assessment can be completed using face to face, video or telephone (audio) consultations. If a telephone consultation is being assessed then please use the Audio-COT assessment form and not the standard COT form 

Selecting consultations

Any consultations you video record will require the patient’s consent. A sample consent form is available below.

The choice of consultations should cover the full breadth of Clinical Experience Groups and be in different settings, such as surgery consultations, home visits and Unscheduled urgent care / Out of Hours.

When you are selecting a recorded consultation, it is natural to choose one where you feel you have performed well. Complex consultations or consultations that you found challenging are more likely to generate learning.

Please note that WPBA and RCA are independent components of the MRCGP Tripos and therefore evidence submitted for one assessment cannot also be used for the other.  All recordings submitted for the RCA should not be utilised for evidence for WPBA. Similarly, a consultation that has previously been assessed e.g. as a COT or Audio-COT may not be submitted for the RCA as it has already been used as evidence for WPBA.

Collecting evidence from the consultation

You will review the consultation with your supervisor, who will relate their observations to the WPBA Capability framework and COT or Audio-COT criteria. The performance criteria for face to face consulting can be found below and for telephone consulting within the Audio-COT section. Your supervisor will grade each section of your consultation, make an overall judgement on your performance and provide formal feedback with recommendations for further development.

When to use the COT

COTs are only completed in primary care placements. Mini-CEXs are completed during non-primary care placements. The total number of COTs required in ST1 and ST2 will therefore very much depend on your placements. A total of 4 Mini-CEXs / COTs /Audio-COTs are required in both ST1 and ST2. The COT/Audio-COT is used solely in ST3.

Download the form

Documents

Consultation Observation Tool (COT) - FAQs

When are COTs done?

COTs are done in all primary care placements.

How many are needed?

In ST1 and ST2 when you are in a primary care post you will need to complete 2 COTs for each 6-month placement. Some areas of the UK have 4 month primary care placements in ST1 and ST2.  It is recommended that 2 COTs are also completed in these posts. A total of 4 COTS / mini-CEXs are required in each training level in ST1 and ST2.

7 COTs are required in your ST3 year. For trainees working less than full time these requirements will be pro-rata.

Do I have to have a certain number of COTs which are face to face and a certain number of Audio-COTs?

No, there is no set requirement of the different types of consultations you experience in Primary Care. Ideally these should not just be solely face to face or audio consultations and a mixture of the different types of consultations would be recommended.

Am I required to complete half of the annual number before each six-month review in ST3?

Yes.

Who can assess a COT?

COTs can be assessed by either an approved GP Educational Supervisor (ES) or an approved, appropriately trained, and updated GP Clinical Supervisor.

Do COTs need to cover all the Clinical Experience Groups?

Over the three-year training programme, it is expected that you will submit COTs related to most of the Patient Experience Groups. However, your Educational Supervisor will be able give relevant advice to you in the context of the rest of your Portfolio.

Is there a minimum or maximum length of consultation to be submitted for a COT?

No. However, brief, low challenge consultations will be unlikely to give adequate opportunity to demonstrate your ability; and overly long consultations may lack structure. It would be expected that COTs are generally 8-15 minutes long.

Can I be awarded a satisfactory Educational Supervisor’s Report outcome if the overall rating for my last COT is ‘needs further development’?

Yes. The Educational Supervisor makes a recommendation to the ARCP panel based on all workplace-based assessment and the overall content of your Portfolio.

Do I need to have a minimum number of ‘competent’ ratings for each of the 12 capabilities?

No. Your Educational Supervisor makes a recommendation to the ARCP panel based on all of your workplace based assessments and the additional evidence you have submitted in your Portfolio. Progress varies from trainee to trainee but you will need to demonstrate competence by the end of training.

Page last updated: 12 October 2020

Audio-COT

General Practice has evolved, and more consultations are being carried out by phone. Different skills are needed to carry out a consultation safely and appropriately on the phone from those needed for face-to-face consultation.

The Audio-COT provides an additional tool to enable the assessment of your telephone consultation skills, which complements the existing components of the WPBA. The Audio-COT uses the same methodology and process of completing the assessment as the COT, but is used in a different setting. The Audio-COT counts towards the total number of COTs you need to do in each training year. 

How the Audio-COT works

Your supervisor will review a number of your telephone consultations during your rotations in primary care, either via direct observation of a telephone consultation or via an audio recording. Your supervisor will discuss the case with you and give you feedback. An Audio-COT assessment is then completed as evidence and documented in your Portfolio.

Selecting consultations for an Audio-COT

You can either be observed directly undertaking a telephone consultation (using a dual headset, for example) or via a recording of the discussion (both patient and doctor).

Complex consultations are likely to generate more evidence. The telephone consultation used for an Audio-COT should typically last between 10-15 minutes.
Telephone consultations should be drawn from your entire period of GP training, reflecting a range of patient contexts. 

Telephone consultations can be complex. It is therefore recommended that Audio-COTs are completed during the ST3 year of GP training. During your primary care placements in ST1 and/or ST2 we would recommend you are assessed following face to face consultations. However due to the increase in telephone consulting this may not be possible and the COT requirement for that placement can include the assessment of your telephone consulting. In ST3 it would be expected for trainees to demonstrate their competence in consulting both in face to face consultations and on the telephone. There is no set number for how many of each are needed.

Telephone consultations are undertaken in both the Unscheduled care / OOH setting as well as in the GP setting and you are encouraged to undertake assessments in both clinical environments.

Telephone consultations can either take the form a telephone triage call or a full telephone consultation. For this reason, not all areas of assessment may be covered in all telephone calls. Supervisors are encouraged to mark ‘not observed’ for those descriptors that are not assessed.

It is natural for you to select telephone consultations in which you feel you have performed well; the ability to discriminate between good and poor consultations indicates professional development. However, you are reminded that the Audio-COT is not a pass/fail exercise. The assessment is part of a wider picture of your overall practice and presenting recordings that you feel perhaps did not go as well as you had hoped may result in greater learning.

Please note that WPBA and RCA are independent components of the MRCGP Tripos and therefore evidence submitted for one assessment cannot also be used for the other.  All recordings submitted for the RCA should not be utilised for evidence for WPBA. Similarly, a consultation that has previously been assessed e.g. as an Audio-COT may not be submitted for the RCA as it has already been used as evidence for WPBA. 

Patient consent

The patient must give consent to the telephone consultation either being listened to by a second doctor or being recorded, in accordance with the guidelines for consenting patients. Please see the separate patient consent document for further information on gaining informed consent for audio recording the consultation below.

Collecting evidence from the consultation

Your supervisor will review the consultation with you, relating their observations to the WPBA Capability framework and Audio-COT performance criteria - see below. Your supervisor will then make an overall judgement and provide structured feedback, with recommendations for further development. You are encouraged to reflect on the telephone consultation through a separate learning log entry.

Capabilities

The Audio-COT has been mapped to the RCGP Capability statements, which in turn will link to work place based assessment evidence in the Educational Supervisor Review.

Trainee rating and overall assessment

Trainees are rated for each area within the Audio-COT as ‘not observed’, ‘needing further development’, ‘competent’ or ‘excellent’. Your supervisor is rating you against detailed performance criteria. ‘Competent’ refers to the standard that would be expected of a GP trainee on completion of their training. A global judgement is made at the end of the assessment tool regarding the safety of the telephone call.

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Audio-COT - FAQs

What is an Audio-COT?

General Practice has evolved, and it is likely that you will carry out more and more consultations by phone. Different skills are needed to carry out a consultation safely and appropriately on the phone from those needed for face-to-face consultation. 

The Audio-COT provides an additional tool to enable an assessment of your telephone consultation skills, which complements the existing components of the Workplace Based Assessment (WPBA). The Audio-COT uses the same methodology and process of completing the assessment as the COT, but is used in a different setting.

When should I complete an Audio-COT?

Audio-COTs are undertaken in primary care placements. They contribute to the total COT requirement for each training year.

During your non-primary care posts the mini-Clinical Examination Exercise (miniCEX) tool is used rather than the COT to record consultation observations. 

Do I have to have a certain number of COTs which are face to face and a certain number of Audio-COTs?

No, ideally these should not just be solely face to face or audio consultations and a mixture of the different types of consultations would be recommended.

It is recommended that in ST1/2 you are assessed on face to face consultations, but if this is not possible then a telephone consultation can be used.

Why use the Audio-COT?

The Audio-COT is a time efficient way of assessing your telephone consulting in a real practice setting and so it is a complete and realistic challenge. It allows you to get feedback on your performance from an experienced clinician about a real patient/scenario, in real time.

Who can assess an Audio-COT?

Either your approved GP Educational Supervisor, or approved, appropriately trained and updated GP Clinical Supervisors can assess Audio-COTs.

What is the process to complete an Audio-COT?

The process is similar to completing a face-to-face Consultation Observation Tool (COT) in the GP setting. GP Supervisors will naturally review a number of your telephone consultations throughout your training in a GP setting, either via direct observation of a telephone consultation or via an audio-recording. To complete an Audio-COT, your GP Supervisor will review the consultation with you, relating their observations to the WPBA capability framework and Audio-COT performance criteria. Your GP Supervisor then makes an overall judgement and provides structured feedback, with recommendations for further development. An Audio-COT assessment is then completed as evidence in your Portfolio (see below for further information about how the form is completed). 

How do I select consultations for an Audio-COT?

You can either be observed directly undertaking a telephone consultation (using a dual head-set for example) or via a recording of both sides of the discussion (patient and doctor).

Telephone consultations should be drawn from your entire period of GP training, reflecting a range of patient contexts. Telephone consultations can be complex, therefore completion of Audio- COTs is recommended during your ST3 year of GP training. 

Telephone consultations are undertaken in both the out of hours (OOH) and the GP surgery setting. You are encouraged to undertake assessments in both clinical environments. Telephone consultations can either take the form of a telephone triage call or a full telephone consultation.  For this reason, not all areas of assessment will be covered in all telephone consultations. GP Supervisors are encouraged to mark ‘not observed’ for those descriptors that are not assessed. It is advised that you complete at least one telephone consultation in the OOH setting and one in the setting of the GP surgery. 

It is natural for you to want to choose telephone consultations where you feel you have performed well. This is not a problem - the ability to discriminate between good and poor consultations indicates professional development. You are reminded that the Audio-COT isn’t a pass/fail exercise; it is part of a wider picture of your overall capability. 

Each Audio-COT should represent a different clinical problem. It is helpful to vary the types of cases that are assessed as an Audio-COT so that your capability is reviewed throughout the cases.

Is there a minimum or maximum length of consultation for an Audio-COT?

No. However, brief, low challenge consultations will be unlikely to give adequate opportunity to demonstrate your ability, and overly long consultations may lack structure.  Complex consultations are likely to generate more evidence. The telephone consultation used for an Audio-COT should typically last between 5-10 minutes. 

How long should the assessment last?

The assessor should give you immediate feedback after the telephone call (which would typically last 5-10 minutes) and then provide a contemporaneous report, rating you and capturing the feedback within the Audio-COT form on the Portfolio. When assessors have provided more detailed written feedback on the Audio-COT this has been very helpful evidence for the Educational Supervisor Report (ESR).

How do I gain patient consent?

The patient must give consent to the telephone consultation either being recorded or having a second doctor listening into the consultation, in accordance with the guidelines for consenting patients. Please see the separate patient consent document for further information on gaining informed consent for Audio-recording the consultation. 

How is the Audio-COT assessment captured?

Educational Supervisors and some Clinical Supervisors have access to your Portfolio. If this is the case, the supervisor can log on and complete the assessment. For those who do not have access to your Portfolio, you should send a ‘ticket’ in advance to the assessor, which will allow a direct link to the online assessment form.

To use the ticketed feedback system you need to generate a new ticket after which the ‘Generate a New Ticket’ page will appear. You should select the ‘Audio-COT assessment form’ and fill in the assessor’s details. An email will then be sent to the assessor providing the login code for the assessor to complete the ticketed Audio-COT assessment form.

What standard am I assessed against?

You will be graded in relation to the standard expected at certificate of completion of training (CCT). Competent refers to the standard that would be expected of a GP trainee on completion of their training. The GP Supervisor is rating you against set performance criteria. The grading scale includes the option of ‘not applicable’ which means that you did not cover the identified area, as it was not within the context of the case. This is different to ‘significantly below expectation and/or below expectation’, which means that either you did not cover the identified area to a competent level, or it was not demonstrated at all, and should have been. An overall assessment of performance is made at the end of the assessment. 

What feedback should I expect?

Your assessor should provide specific, constructive feedback both verbally and documented on the Audio-COT form, which aims to enhance your performance. The feedback will be used as evidence of your progress within ESR. The comments about each assessment area are important. Areas of strength and suggestions for development are both encouraged. 

Is the Audio-COT mapped to the 13 Capabilities?

Yes. The Audio-COT has been mapped to the RCGP capability (competency) statements, to allow the linking of workplace-based assessment evidence in the ESR.

Do I need to cover all the clinical experience groups?

Over the GP training programme, it is expected that trainees will submit a breadth of WPBAs relating to all the clinical experience groups. However, the Educational Supervisor will be able give relevant advice to individual trainees in the context of the rest of their Portfolio.

Does it matter what level of complexity is recorded for Audio-COT cases?

No, however it contextualises the subsequent grades. You would be expected to complete the breadth of complexities and bear in mind low complexity consultations will be unlikely to give adequate opportunity to demonstrate your ability.

Can I be awarded a satisfactory Educational Supervisor’s Report outcome if the overall rating for an individual Audio-COT is ‘needs further development’?

Yes. The Educational Supervisor makes a recommendation to the ARCP panel based on all your overall workplace-based assessments and the content of the Portfolio.

Can the Audio-COT be used for online / Skype style consultations?

The Audio-COT form could be used in other types of remote consulting where you are not consulting face to face in the same room as your patient in a GP setting (virtual consultations). Examples include the evolving digital audio/video consultations via mobile applications e.g. ‘Skype’ which are being introduced into the primary care setting. Please await further information on the extended use of the Audio-COT. 

How do I access the Audio-COT form?

The Audio-COT form can be found in the trainee Portfolio or downloaded via the RCGP WPBA website

How is the Audio-COT assessment captured?

If you have any queries about using the Portfolio, please contact FourteenFish via www.fourteenfish.com/support where you can find a “Submit a request” form.

Queries regarding training

If you have a query about the training then it is appropriate to contact either the trainee’s Educational Supervisor or the local GP Training Programme Director/Associate Dean to discuss these further. 

For any general queries about your GP training and assessment or the content of the WPBAs please contact the RCGP.

Clinical Examination and Procedural Skills (CEPS)

It is essential you learn how to examine patients within the general practice setting.

To be awarded your CCT, evidence for the following must be included:

  • The five mandatory intimate examinations. A suitably trained professional will need to observe and document your performance on a CEPS evidence form.
  • A range of additional Examinations and Procedural Skills relevant to General Practice which demonstrate new learning.
  • Your supervisor must also be satisfied through observed evidence or documented evidence from others that you are competent in general and systemic examinations for the clinical curriculum areas. These may well have been completed in your previous training but can be easily covered in joint surgeries for example.

Introduction

Proficient Clinical Examination and Procedural Skills are fundamental to effective general practice. Relevant evidence for this Capability needs to be gathered regularly throughout each review period and recorded in your Portfolio. As with the other Capabilities there are sets of word descriptors to help you reflect on your progression as you acquire these skills.

Which skills need to be assessed?

By the end of training your Educational Supervisor must have observed or have documented evidence from others that you are competent in general and systemic examinations in the clinical curriculum areas. 

There are also 5 intimate examinations which need to be specifically included, as these are mandated by the GMC. These include breast, rectal, prostate, male genital examination and female genital examination (which includes a speculum and bimanual pelvic examination). 

You need to be observed performing the intimate examinations by a suitably trained professional. The assessor records their observation on the CEPS evidence form. If this is another doctor they must be at ST4 level or above, or an SAS equivalent. If the colleague is another health professional, such as a specialist nurse, they must confirm their role and training so that your Educational Supervisor can be satisfied that they have been appropriately trained. 

You may also decide to write a separate log entry on any of these specific skills.

It is also important to note that this is not an exhaustive list of intimate examinations and indeed any examination can be considered intimate by some patients (for example, a competent examination of the eye with an ophthalmoscope), but the examinations listed are those that, due to their particularly intrusive nature, need to be specifically observed, and commented on, during your training.

The 5 mandatory examinations are not a 'minimum requirement' and cannot by themselves demonstrate overall competence in CEPS. A range of CEPS which are relevant to general practice are also required. This again is not an exhaustive list, nor is there a set minimum number as everyone has different needs. You are expected to document your performance in CEPS in your learning log and/or discuss your learning needs during placement planning meetings with your supervisors. The range of examinations, procedures and the number of observations will depend on your particular requirements and the professional judgement of your Clinical and Educational Supervisors.

For example, you may recognise that your learning needs include more experience of joint examinations, the examination of the eye, or doing a newborn baby check. You may wish to discuss with your supervisor how these can be addressed. Your supervisor may also recognise areas that need to be addressed such as completing a neurology examination within a GP-length consultation, or examining a diabetic patient’s feet correctly.

You may already be aware of specific CEPS you want to address but these can equally become apparent during your consultations with patients.

In addition, it is important to recognise the procedures you may need during emergency presentations in General Practice. For example, can you explain to a patient who is having an asthma attack what you are going to do in setting up a nebuliser?

Completion of CEPS

These can be completed in a variety of ways:

  1. CEPS evidence form (in the assessments section of the Portfolio)
  2. Learning logs (there is a filter for CEPS entries)
  3. MiniCEX
  4. COT 

You will not be able to be signed off as competent in CEPS by your Educational Supervisor during your final review unless they are satisfied you are competent in general and systemic examination of the clinical curriculum areas, the 5 mandatory intimate skills and a range of CEPS relevant to General Practice. This will also be reviewed at your ARCP panel and an unsatisfactory outcome given if these are not present.

Page last updated: 15 July 2021

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Clinical Examination and Procedural Skills (CEPS) - FAQs

What is the range of evidence I need for CEPS?

Apart from the five mandatory examinations as required by the GMC it will be up to you to discuss your learning needs with your Educational Supervisor.  The CEPS to be considered and the range of evidence required will depend on various factors such as your prior experience and the nature of your current placement.  Remember that you are training to be a GP and so procedures that are unlikely to be performed in a GP setting, whilst interesting to reflect on, are not so relevant.  Nevertheless all examinations and procedures have some common features such as the need to gain consent and the need to consider the comfort of the patient.

What are intimate examinations? Is there a definition?

There is no agreed definition of what constitutes an intimate examination.  The five examinations for which evidence of competence is required by the GMC are generally accepted examples of intimate examinations but there are many others.  For instance, the competent examination of the eye with an ophthalmoscope is considered by many, if not most, patients to be an intimate examination, especially as it requires the examination room to be darkened.  Ultimately it is the individual patient who determines what is intimate or invasive for them and this will be determined by a number of possible factors including their prior experiences, their religion and their cultural background.

How many CEPS do I need to do?

There is no set number. There needs to be enough to demonstrate, to your Educational Supervisor’s satisfaction, your competence in CEPS.

What is the standard of clinical examination expected?

The standard is that of an independent fully qualified General Practitioner.  As well as the technical aspects of examination and the ability to recognise abnormal physical signs, it includes the choice of examination best suited to the clinical context. For instance, a competent GP very rarely performs an extensive neurological examination but will perform a limited neurological examination as determined by the history taken from the patient.

Can CEPS be assessed in a skills lab?

Training in a skills lab and the use of manikins can be a very helpful adjunct to training in the work place.  In general, and certainly in the case of the five intimate examinations as required by the GMC, this will not be sufficient evidence of competence without the demonstration that your skills can be applied in a clinical context.

Would an observed full insurance medical examination be enough evidence?

Although being observed performing such an examination might be helpful it would be unlikely to provide sufficient evidence of clinical competence.  For instance, the extent of the examination in such a situation is determined by the insurance company and not by the clinician.

If I have demonstrated competence in an intimate examination does this need to be repeated?

No, if your Educational Supervisor is satisfied that the evidence you have provided for one of the five intimate examinations as required by the GMC is sufficient this does not need to be repeated.  However, it is important that this evidence is recorded in such a way that you can remember where it is.  The easiest ways to do this is to use the CEPS forms.  At the final review before a Certificate of Completion of Training (CCT) is recommended your Educational Supervisor will need to answer a specific question in relation to these examinations.

What if I am unable to complete a CEPS due to disability?

All GP trainees, including those with a disability, are to meet the required competences to ensure patient safety. This includes having the insight to:

  • recognise when a disability prevents completion of an examination 
  • understand the examination required, and that it is a necessary part of the consultation
  • facilitate a patient examination in a timely fashion
  • demonstrate that the trainee knows what to do with the findings. 
  • If a trainee feels this guidance may apply to one of their examinations (regardless of whether it is a mandatory examination or not) they should discuss this with their educational supervisor/programme director in the first instance. 

For example, one possible approach might be that a trainee who cannot physically carry out an examination refers the patient to a colleague to carry it out. 

In a training context, to satisfy the CEPS requirement, the observer (who could be the person who performs the examination) should document on the assessment form the part of the CEPS they did observe, and document why it was necessary for the examination to be done in this way. 

This should be added into the observation and feedback performance box on the assessment form.

Multi-Source Feedback (MSF)

The Multi-Source Feedback (MSF) tool is used to collect your colleagues’ opinions on your clinical performance and professional behaviour. It provides data for reflection on your performance and self-evaluation. 

The Multi-Source Feedback takes place in every year of training and you need a minimum of 10 respondents each time. In ST3 you will also need to do a leadership MSF in addition to this MSF and this is described later in this manual.

Preparing for the MSF

You need to agree a date to conduct the MSF with your Educational or Clinical Supervisor, and set aside time after the closing date so you can discuss the feedback generated.

Complete the self-assessment and then select the respondents.

  • In non-primary care placements, you will need to select 5 clinicians and 5 non-clinicians who know your work well. It is recognised that identifying 5 non-clinicians might be more challenging in some posts, in which case more clinicians may be asked. Your respondents should come from a variety of roles and include people with a range of seniority.
  • In primary care, 5 clinicians (usually established GPs) and 5 non-clinicians are required and again it is advised you choose people who know your work through working alongside you.
    It is recommended you ask more than 10 people, i.e. 15 people to ensure you get 10 responses.
  • From your Portfolio you will need to start a survey and complete your self-assessment. You will need to add your colleagues' details (name, email address and role). Once you have added at least 10 colleagues, you will be able to send an email invite to your respondents through the Portfolio. Respondents need to click the link in the email to complete the survey. Their answers are anonymous, but please note your supervisor will be able to see details of people invited to complete the survey.

Using MSF feedback

Your Educational Supervisor will have access to the anonymised results once the MSF closes. Once authorised by the Educational Supervisor, the results will be available to you through your Portfolio.

You will then have a feedback discussion with your Clinical or Educational Supervisor and an opportunity to reflect on the results. You can record this discussion and the resulting action plan in your Learning Log / PDP.

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Multi-Source Feedback (MSF) - FAQs

How many MSFs do I need to complete during training?

You will need to complete one MSF in ST1, one in ST2 and one in ST3. During ST3, you will also be required to complete a leadership MSF.

Why do we have to complete a Self assessment?

This is so you can compare how you think you score in the areas concerned to the scores given to you by your colleagues.  This requirement has been set by the GMC.

I am trying to complete a colleague response but it says it has already been completed?

If you are sure that this is not yourself who has done this then it may be that another colleague has done this by mistake. If you contact the colleague who is subject of the 360 they can add you again onto their survey.

How many colleagues do I need to get to complete the survey?

10 respondents are needed for each MSF. This should normally be 5 clinicians and 5 non clinicians. It is recognised that to find 5 non-clinicians in a non-primary care post might be difficult and in this situation it would be acceptable to ask more clinicians. 10 replies are the minimum number and the assessment will not count without this number.

For each MSF we would recommend asking more than 10 people to ensure you do reach the minimum number.
 
Why won’t my Portfolio let me send out the invitations?

You need to submit details of the minimum number of colleagues AND complete your self assessment before the system will let you send out the survey invitations.

Can I see who has responded?

If you log into to your Portfolio and visit the survey setup page you will see how many of your colleagues have responded but not which individual.

How do I remind colleagues who have not responded?

The Portfolio automatically sends out reminders if colleagues have not responded within 10 days of the initial invitation.

I have had an email saying the survey can be closed. What does this mean?

This means that you have had enough recipients to be able to complete the survey. You don't have to close the survey and can wait longer to give more colleagues the chance to respond. Once the survey is closed, if any of your colleagues try and complete the survey they will be notified that it is has been completed. Your Educational Supervisor (ES) will be notified when you have closed the survey and they will be able to review this before releasing it to you.

I think I can identify who has made an upsetting comment. What should I do?

Whilst we want MSFs to be anonymous, you may be able to identify individuals who have written certain comments. We would suggest discussing this with your ES should this occur.

I am completing the survey for a colleague. Will they be able to identify me?

Your colleague will not see any names in the completed summary report.

How is my data held?

It is held securely and in accordance with the General Data Protection Regulations. 

Page last updated: 1 March 2021

Patient Satisfaction Questionnaire (PSQ)

The Patient Satisfaction Questionnaire (PSQ) provides patient feedback on your empathy and relationship-building skills during consultations.
It is completed once in ST3 and it recommended you do this after the mid-way point of your time in ST3.

Patients are requested to complete the questionnaire after their consultation and are asked 9 questions. Each question has 5 options for them to choose from. It is worth familiarising yourself with the questions before starting the PSQ process.
You may have to remind patients to complete the questionnaire after their consultation and hand in the completed form before they leave the surgery as it can sometimes be a challenge to get sufficient responses.

How to complete the Patient Satisfaction Questionnaire 

  1. Log into your Portfolio and click on ‘Patient Feedback’. 
  2. Complete the self-assessment (this is the score that you would give yourself for each question). 
  3. There are several ways to complete the assessment, either by sending the patient a link to complete the questionnaire online from your Portfolio or downloading the form and printing it off. We would recommend the form is sent electronically especially as so many consultations are now done over the telephone (it is acceptable to complete the assessment following telephone consultations in addition to face to face consulting).
  4. If you are planning on using paper copies of the questionnaire, give these to the receptionist to hand out to patients before they come to see you. If you do not have a receptionist to do this, then please look at alternative options. You should not be handing questionnaires to patients. 
  5. The completed questionnaires should be handed back at reception or left in a sealed box in reception. The forms should not be handed to you. 
  6. Once you have more than 34 responses, the data will need to be entered into the Portfolio. This should not be done by you. Please discuss this with your practice manager as usually an administrative member of staff will complete this on your behalf.
  7. Once more than 34 responses have been entered into your Portfolio, you will be able to close the PSQ.
  8. Your Educational Supervisor will receive a notification that the PSQ has been completed. They will review the results and comments and will add their own comments and feedback in the Portfolio. 
  9. You should arrange a meeting to discuss the PSQ with your ES. 
  10. If your scores are significantly below the average of your peers, then it would be appropriate to repeat the PSQ at a later date to demonstrate progress.

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Documents

Patient Satisfaction Questionnaire (PSQ) - FAQs

How many PSQs do I need to complete?

You will need to complete one PSQ during ST3.

How do I collect the data?

There are several ways to do this. From your Portfolio you can send the patient can be sent a link to complete the questionnaire online or you can download a paper copy and ask your reception staff to hand out the questionnaire to patients.

How many responses do I need in a PSQ?

You need at least 34 responses.

How are the paper forms uploaded?

The paper forms should be collected by an administrator (not yourself). You will need to invite an administrator to enter the data to the Portfolio. To invite an administrator, go to your survey and scroll to the bottom of the page, where you will see the section for printed forms. There are instructions explaining how the paper forms can be uploaded to the system. You can email the instructions to an administrator who will be able to add the PSQ forms for you using the provided ID and password.

Example:

Print out the questionnaire screenshot

How will I know when I have had the electronic forms completed?

A number count is displayed on the survey page in the Portfolio so you know how many have been returned.

Example:

Can I add paper forms to the electronic questionnaires?

Yes, your administrator will be able to add these for you. Please see "How are the paper forms uploaded?" for information about how your administrator can upload the paper forms. Any forms uploaded by an administrator will be added to the questionnaires completed electronically.

How do I close the PSQ once there are 34 electronic responses?

You will receive an email notification when you have obtained the minimum of 34 responses, this is when you can close the survey. To close the PSQ, go to your survey and click "close survey" in the "your progress" section. This will send the PSQ results to your Supervisor for analysis.

How can I see the results?

Once you have closed your PSQ, the results will be released to your Supervisor. They will then be able to review the results, comment on these and release them to you.

Page last updated: 14 October 2020

Leadership activity and MSF

Leadership skills are an essential component to the everyday work of a GP. This is reflected in the RCGP Curriculum and Topic Guides and GMC Generic Professional Capabilities. Good leadership skills enable improvement of health outcomes, high quality patient care and fulfilling work environments for staff, by inspiring and empowering all who journey towards a shared vision. Leadership is a skill that everybody can learn and requires continuous development and refinement. Whilst there are aspects of theory to learn, the most important learning in leadership is from practicing the skill set. The Leadership Workplace Based Assessment (WPBA) gives all trainees the opportunity to gain practical experience in developing these skills in primary care.

Mandatory requirements for WPBA

  1. A Leadership Activity will be undertaken in ST3. You can propose your own activity or select from the examples in the leadership WPBA manual below. In all cases the proposed activity should be discussed and agreed with your Educational or Clinical supervisor to ensure its suitability. The activity will be recorded in your Portfolio by writing a reflective entry using the specific leadership log entry template.
  2. The second MSF in ST3 will be a Leadership MSF with questions specifically focused on obtaining feedback around your leadership skills. Ten respondents are required. These should include people who were involved in your leadership activity but is not confined to just this group as the questions also ask about your leadership capabilities which may not have been included in this activity.  

In addition trainees are encouraged to develop their leadership skills incrementally over their training programme and record any other leadership activities undertaken. There are a variety of ways to record evidence of leadership activity within your Portfolio:

  • Log Entries: Leadership activity experience and reflections, along with any learning points should be recorded in the Portfolio.  There is a specific leadership log entry template that should be used to record leadership activity.  This could provide evidence for the capability ‘Organisation, management and leadership’, and may also provide evidence for other Capabilities , for example ‘Working with colleagues and in teams’, and activities such as ‘audit and quality improvement’.
  • PDPs: The PDP could be used to record areas around leadership activity that you may wish to develop during your training.
  • CATs: A Case based discussion can be a good opportunity to discuss feedback on and develop areas around leadership.

Approaching the Leadership WPBAs

Leadership log entry

Suggested Capability links
Date
Title of event
 
1. State your role in relation to the activity  *
2. How did you approach this activity? * [what planning you undertook for the activity]
3. How did you demonstrate your ability to work with colleagues, patients, learners and/or users (individually or in teams)? *
4. How effective were you within this role? * [reflect on your achievements and feedback received]
5. Reflection: what will I maintain, improve or stop?
6. What have you learnt about yourself? * [consider what motivates you, your core beliefs and areas to develop]

Leadership Activity - FAQs

Is participation in a leadership activity mandatory?

It is mandatory to do a leadership activity in ST3 and write this up using the specific log entry for leadership activities.

It is mandatory to do a second MSF in ST3 which will be a leadership MSF, with questions relating to the trainees leadership skills.

How is it assessed?

It will be assessed using the descriptors for the organisation, management and leadership competency.  This is done by the educational supervisor using evidence directly observed, log for leadership activity, MSF and CbDs , which link to leadership activity.

Can I do a leadership activity out with the specific examples given?

The list provided is to give ideas and examples, but includes trainees own ideas.  This should be discussed and agreed with educational supervisor in advance, in the same way any other leadership activity on the list would be.

Are trainees expected to have protected time to do their leadership activity?

There is educational time included in the GPSTR contract and all GPSTRs are expected to have protected personal study time as part of their working week as well as time in groups for shared learning. The WPBA package has changed with addition of some "new" areas of workplace based assessment like leadership and the removal of other expectations (some CbDs etc).

Does the leadership activity have to be done in the practice or in primary care?

The leadership activity is done as part of the training to become a GP. It is therefore necessary that the activity is done within the normal work that a GP would be expected to be involved in. This might therefore include work with commissioning organisations, networks of primary care teams or with District Nurses, palliative care teams or others with whom GPs regularly work.

When can the leadership activity be started?

It is expected that the ST3 leadership MSF will be linked to the leadership activity, so that the people who provide feedback through the MSF will have seen evidence of your leadership skills, (these are not confined to just the leadership activity). Although some elements of the leadership activity could have started before ST3 it is required that the ST3 leadership activity is completed during ST3.

Leadership Multi Source Feedback (Leadership MSF)

Once you have completed the leadership activity, the Leadership focused MSF then gives the opportunity for you to receive some feedback from colleagues on your leadership skills. The exercise has been designed to evaluate your strengths in leadership and to reflect on where you need to concentrate your efforts before becoming an independent practitioner. 

Guidance for the use of the MSF

Your leadership activity needs to have been completed before you start the MSF. 

Prior to requesting your colleagues to complete this form you need to complete a self-assessment. This will enable a comparison to be made between the two sets of results. 

The more respondents who complete the MSF the more useful the results.  It is therefore suggested that you consider a wide range of colleagues, both within the organisation in which you work day to day and also colleagues with whom you have contact outside the organisation. The respondents should include people who were involved in your leadership activity but is not confined to just this group as the questions also ask about your leadership capabilities which may not have been included in this activity. 

Your respondents are asked to answer 5 questions, each with a rating scale, and to comment on any highlights of your leadership, and suggest areas for improvement.
As with all MSFs, the results will be made available to your Educational Supervisor to access first and then released to you. You should arrange to meet with your Educational Supervisor to allow discussion and feedback with the creation of a personal development plan if required.

Notes for Clinical and Educational Supervisors

A significant part of the value that comes from a leadership activity is being observed and having formative feedback from the Educational supervisor, or an appropriate deputy, within the practice.  This will support your trainee in reflecting upon their strengths and how they can improve in other areas as they continue their leadership journey, which requires career-long learning. This can be done both verbally, e.g. during a tutorial and also in a written format, e.g. through comments relating to a log entry, a CAT, the leadership MSF or an educator’s note.

If your trainee is performing below the level expected for their stage of training it is important to be specific about why this conclusion has been reached and develop a plan the trainee can follow to try and alter the situation.

For many leadership activities it is important that an appropriate environment is created. The environment should be one that expects the trainee to undertake this work, facilitates this process and allows the trainee to feel comfortable in their role, for example when giving feedback to their practice as part of a fresh pair of eyes activity.

Preview the form

Leadership MSF - FAQs

When do I have to do the leadership MSF?

This is completed once in ST3 and ideally after your leadership activity. This normally will take place in the second half of ST3. You will have already completed the MSF rating your clinical and professional behaviour in the first half of ST3.

Does a written reflection need to be made?

Yes. Reflections on the feedback need to be recorded in a ‘Reflection on Feedback’ log entry. A PDP item can be developed if needed.

How many responders are required?

As with any MSF 10 replies are needed. These can be either clinical or non-clinical respondents. There are no defined number of clinical or non-clinical responders required.

What if insufficient responses are submitted?

If you are working in a very small practice it may not be possible to be able to achieve sufficient responses. In this circumstance, the Educational Supervisor should make an Educator’s Note stating that there are insufficient members of staff to complete your leadership MSF.

If I receive negative feedback or areas for improvement are identified, does the Leadership MSF need to be repeated?

No. You should record your reflections in the feedback section of the learning log and develop a personal development plan to address any needs. The Educational Supervisor can comment on these reflections and PDP.

Do all the respondents have to be part of my leadership activity?

No, it would be expected that people who were involved in your leadership activity are asked to complete your MSF, but is not confined to just this group, as the questions also ask about your leadership capabilities which may not have been included in this activity. 

Documents

Useful resources from the Faculty of Medical Leadership and Management:

  • Developing medical leadership [PDF] - a toolkit produced in partnership with Health Education England signposting opportunities for leadership development
  • How To guides - a collection of practical resources to help junior doctors complete projects

Page last updated: 31 March 2021

Quality Improvement Project (QIP)

The GMC recommends that all doctors demonstrate an involvement in Quality Improvement at least once a year.  During your GP training you are expected to complete a Quality Improvement Project (QIP) when you are in your primary care placement in either ST1 or ST2 and a Quality Improvement Activity in any other training year.
 
By the time you reach the end of training you need a minimum of 1 QIP and 2 QIAs. 
 
As a trainee you are in good position to identify areas of practice that frustrate you and that possibly have an impact on patient safety. QIPs are about making small incremental changes and measurements, which allow you to evaluate the impact of your changes both quickly and successfully.  The QIP should be written up in your Portfolio (there is a separate section to write up your QIP, which is different from the QIA learning log) and your supervisor will both assess, grade, and discuss this with you.

How to undertake a QIP

There is a lot of information below with ideas for QIPs, if you are unsure what to do. Guidance on the tools used and completed templates which have been marked by supervisors are there to guide you. It is suggested you look at this section before starting your QIP. 

The Model for Improvement is a recognised tool for undertaking a Quality Improvement Project in a health care setting and can be used as a framework to help you. It asks three questions:

  1. Aim – What are we trying to accomplish?
  2. Measure - How will we know if a change is an improvement?
  3. Change - What changes can we make that will result in improvement?

First of all you need to decide what the aim of your project is going to be. 

Projects can be chosen following a significant event, a patient complaint; or an area of care you feel passionate about. 

Do not make your project too complicated; it needs to be completed within your primary care placement in ST1/2.

The project should aim to improve patient safety or care and be ‘SMART’.

  • Specific - do not make it too broad and chose something you are interested in. Words such as increase / reduce help to set a clear goal.
  • Measurable – ensure that there is something you can easily measure to demonstrate any change. It can be qualitative data (descriptive) as well as quantitative data (numerical data).
  • Achievable - ensure the data is easily collectable and keep the aims simple.
  • Relevant - project should be focused on patient safety.
  • Time defined – choose something that can be done in your time frame. You need to be able to complete your project in your primary care placement. 

For example a ‘SMART’ aim looking at doing 6 week baby checks in a timely manner could be ‘To improve the percentage of 6 week baby checks performed between the start of week 6 and by end of week 8’. 

The QIP template requires you to describe your QIP in logical steps. This is then reviewed and graded by your ES. word pictures to describe the grading for each section are below.

Introduction to QIPs

Training resources

QIP ideas and completed QIPS with ES feedback

Quality Improvement Project (QIP) - FAQs

Why do a QIP project?

The GMC is clear that all doctors in training will have to participate in Quality Improvement work throughout their training. The RCGP has designed a tool and process, which enables participation early in training. The skills learnt during this project can be put into practice throughout training. 

When do I need to do the QIP?

The QIP project is a mandatory assessment which should be completed in either ST1 or ST2 when you are in a primary care placement. 

Can I do my QIP in a non-primary care setting?

The idea of the QIP is for you to demonstrate your understanding of quality improvement and how this is evaluated. As GP trainees we would recommend this is done in primary care and the subject of your QIP is relevant to Primary care. If this is not possible for whatever reason, then the QIP can be done in a non-primary care setting but we would recommend you discuss this with your GP supervisor first as it is them who will need to mark the QIP and give you feedback.

Is it a mandatory assessment?

Yes.

What do I have to do?

You are required to undertake a QIP, then complete the QIP template demonstrating learning and reflection. The project should be uploaded to provide proof of undertaking the activity in addition to completing the QIP template, which requires reflection on what has been learned as a result of reviewing the process of doing the project. Your GP supervisor then assesses the QIP project and Portfolio and feedback is given to you by them, which should encourage further discussion. Guidance should be given by the local GP education team and/or utilising wide range of resources available on the RCGP WPBA website.

Can I fail the assessment?

The assessment is not a pass/fail exercise, however if you are consistently below expectations when assessed by your supervisor, it might be recommended to repeat the exercise, or a component of it and write a follow up learning log entry.

It is though mandatory to complete the assessment. 

What are the feedback levels?

You are given the following feedback levels: below expectation, meeting expectation or above expectation for each domain compared to the expected level of a GP trainee working in the clinical post. The supervisor also rates you on your overall competence. 

What would an unsatisfactory QIP look like?

Indicators of an unsatisfactory QIP would include:

  • No team engagement
  • No engagement of stakeholders (people affected by change including patients)
  • Minimal measurement
  • No real attempt at implementing change, just a discussion that change should happen

Please refer back to the RCGP WPBA QIP Word Descriptors to gain a further understanding of what is required within the project and write up.

Do I need to do any other QI activity during my training?

Yes, you have to demonstrate involvement in quality improvement annually. In the training year when you are not doing your QIP then you will need to do an quality improvement activity. Please see the QIA section for further information.

What is the difference between an audit and a QIP?

Both aim to improve patient care. Audits are more formal and tend to be done over longer time frame; an audit cycle includes setting a standard, collecting data, analysing the data, implementing change(s) and then repeating the cycle. Model for improvement is often used as framework to do QIPs. This has been shown to test changes successfully and quickly. The PDSA cycle is iterative (repetitive with the aim of approaching a desired goal and the results of each repetition used as starting point for next iteration). PDSA cycles can be done often e.g. weekly. They generally tend to generate enthusiasm and be less tiring.

Can I just do an audit?

No. The methodology is different (see above question). It is expected that specific quality improvement tools are used e.g. the model for improvement, Plan Do study Act (PDSA), process mapping, run carts, fishbone diagrams, driver diagrams and Gantt charts. See the RCGP website for further information on these tools. 

Can I submit a project that I have worked on with a colleague?

It may be appropriate to work with a colleague to complete a larger QIP/QIA in the practice, or across multiple sites. However, it should be clear what work the trainee completed. The reflection should describe the trainees personal involvement in the activity and their personal reflection. The trainee can compare their data or the practice/department as a whole depending on the project. It might be appropriate for a colleague to run a computer search to gather data, however it would be encouraged for the trainee to learn how to undertake an appropriate computer search. It would be encouraged for the trainee to lead the project to gain full experience of completing a QIP whilst being supported by their supervisor/colleagues.

I don't know what to do my QIP on?

Ideally the QIP needs to be an identified need in the trainees local practice however there are lots of ideas on the RCGP WPBA website to help get trainees started.

What resources are available to help me?

There are a range of resources to help trainees and educators with marking and assessment of this project available on the RCGP WPBA website. These include training resources for individuals or schemes, mock examples and completed marking of these as well as a list of projects of this size which have already been completed at this stage in GP training. 

Which capabilities does the QIP map to?

The QIP contributes to evidence in the relevant capabilities: Fitness to practice; maintaining performance learning and teaching; data gathering and interpretation; working with colleagues and in teams; organisation management and leadership.

I have done a QIA, why is it not counted against my QIP?

The QIP is a new stand alone template and is counted separately to QIAs. Please see the QIA section below.

Quality Improvement Activity (QIA)

The GMC recommend that all doctors demonstrate involvement in Quality Improvement at least once a year. 

During your GP training you are expected to complete a Quality Improvement Project (QIP) when you are in your primary care placement in either ST1 or ST2 and a Quality Improvement Activity in both of the other 2 training years.

The QIP is covered in more detail in the QIP section.

By the time you reach the end of training you need a minimum of 1 QIP and 2 QIAs.

The definition of QIA covers a wide range of activities (see FAQs).

The QIA should be recorded electronically in your Portfolio.

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 activities, which use a different methodology to audit, (however audits are still considered in the wider environment to be a quality improvement activity and would count as a QIA).  The QIA reflection should involve a personal connection to the work and include an element of evaluation and action, and where possible, demonstrate an outcome or change.

Please note you do not need to also do a QIA in the same training year as your QIP.

For the purposes of GP training, Learning Event Analysis (or Significant Events) and Reflection on Feedback do not count towards your annual QIA requirements. The QIA reflective log specifically involves taking some action as a result of data. Involvement in QIA throughout your training ensures you are equipped with appropriate quality improvement methods for lifelong competence.

Quality Improvement Activity (QIA) - FAQs

What QI activity do I need to do during my training?

The GMC recommend that all doctors demonstrate engagement in Quality Improvement at least once a year. You are required to demonstrate that you regularly participate in activities that review and improve the quality of your work for the purposes of revalidation. When qualified, it is a requirement each year at your appraisal to demonstrate that you have been involved in quality improvement activities (QIA). Engagement with QIAs during training ensures you are equipped with appropriate quality improvement methods for lifelong competence. 

The Quality Improvement Activity reflective learning log entry should be used to capture QIA across the full training programme (which is separate from the required QIP - see below). The quality improvement activity should be robust, systematic and relevant to your work. Your reflection should include an element of evaluation and action, and where possible, demonstrate an outcome or change. 

What is the difference between the QIP and annual QIA?

A Quality Improvement Activity is a more broad term which encourages doctors, both qualified and in training to evaluate the quality of their work in addition to what works well in the clinical environment, to promote and consider change where appropriate. QIA also encourages reflection on the changes (if any) that are made.

Do I need to do a QIA the same year as completing the mandatory QIP?

No. The QIP needs to take place in a primary care placement in either ST1 or ST2 and QIAs in the other training years. 

What counts as QIA?

QIA can take many forms; the QIA is intended to be a smaller activity than the formal QIP. Although you are encouraged to think about quality rather than quantity of any QIA.  The QIA should involve a personal connection to your work and look to create an improvement and/or change, which requires action to be taken. The following are suggested types of QIA suitable to be completed annually which involve taking action as a result of data:

  • a review of personal outcome data through case reviews e.g. referral review
  • involvement in large scale national audit with data collection at an individual/practice level
  • small scale data searches which could include reviewing prescribing (separate to the prescribing assessment)
  • small specific QIP using plan/do/study/act (PDSA) cycles
  • writing or revising a practice policy
  • monitoring and evaluation e.g. patients on DMARDS or warfarin using PINCER data
  • ‘search and do’ activities involving information collection and analysis

The GMC counts Learning Event Analysis as part of QIA, why can I not just use this as this evidence for the year?

It is a separate mandatory requirement to complete at least one Learning Event Analysis (LEA) per year. A Significant Event should be completed should the event reflected on reach the GMC threshold. It is recognised that LEA/SE will demonstrate how you review and learn from both positive and negative events and incidents;  in many cases the learning will also lead to quality improvement activity however the aim of the QIA focuses on reflection following data collection.

Why does feedback received, compliments/complaints not count as QIA?

A separate reflective log entry has been created to reflect on feedback received from any source (not a mandatory requirement). This could be feedback from an assessment including multisource feedback, the trainees educational supervisor review, other solicited or unsolicited feedback and a compliment/complaint. Although feedback may lead to QIA through the nature of personal reflection on a specific case, the QIA strives to empower you to look at areas for change/improvement within the clinical setting more broadly.

Prescribing Assessments

Prescribing is an integral part of a General Practitioners work and several high profile cases have been published when qualified doctors have made catastrophic errors. In 2017 the GMCs published a document describing Generic Professional Competences. These are competences, which every speciality trainee needs to achieve before the end of training and they include prescribing as one of their key areas. GP trainees are not currently assessed on their prescribing in the workplace and it was felt that this needed to be rectified as a priority.

The assessment consists of a self-assessment prescribing review based on the PRACtlCe study and REVIST studies. These were GMC led reviews looking at the number of times errors were found in prescriptions. The results were alarming with 1 in 20 prescriptions containing an error. The REVISIT study looked specifically at prescribing by GP trainees and the error rate rose further to 1 in 10 prescriptions. The RCGP subsequently worked with the Nottingham team to create an assessment suitable for GPs in training.


The assessment is a formative exercise to reflect on prescribing practice, which should highlight trends and learning needs within your prescribing. By reflecting on the errors identified it will enable learning plans to be put in place in order to improve your prescribing in the future. There is no set standard as it is designed as a learning exercise; however if no errors are highlighted and if no learning is identified this would raise concerns, as to date this has never been the case.

Full details are below but in summary

  1. The trainee searches on their last 50 retrospective prescriptions
  2. Using the prescribing manual, the trainee reviews these prescriptions and maps them against potential prescribing errors
  3. The GP trainer / Supervisor reviews 20 of these prescriptions, maps these against potential errors and adds these to the spreadsheet 
  4. The trainee completes the trainee reflection form in the ePortfolio and in particular reflects on their prescribing using the GP prescribing proficiencies
  5. The trainee and GP trainer / Supervisor complete the assessment using the GP trainer/ Supervisor assessment form found in the ePortfolio
  6. Both the trainee and GP trainer / Supervisor complete and submit the questionnaires
  7. The trainee uploads the anonymised spreadsheet to their learning log
  8. Supporting documents which outline the assessment in detail can be found below

Documents required to complete the assessment

How to search for prescription items

You are required to collect the data for 50 prescriptions. Many of you will need to do this by looking through all of your consultations backwards, from a particular date and identifying when you have prescribed a medication. You will then need to manually enter the information onto the spreadsheet.

For some of you, we have managed to work with the patient management systems (PMSs) to create a search function that can gather some of the data for you. Those with this ability are fortunate as we did not envisage we would be able to utilise this and it ensures that none of your scripts are missed.

Whilst we have tried to work with as many PMSs as possible, for some, this is not available, for others, they were unable to do this due to other commitments.

We will continue to try and work with the PMSs to provide as many trainees with an automated search but we are aware that there will be many of you who will not be able to take advantage of this and will therefore have to return to the default position of manually gathering the data.

Page last updated: 8 October 2020

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