Progressing as a Foundation Doctor: Monitoring progress through the Foundation programme

1
Progressing as a Foundation DoctorMonitoring
progress through the Foundation programme

• Frank Local
• Dean Director (Acting)
• Northern Deanery Foundation School

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Monitoring trainees

• The trainees making good progress is not a
  problem
• Struggling trainees need to be identified and
  supported (and regulated)

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How do struggling doctors come to light?

• Single critical event
• Chronic underperformance
• Substandard clinical performance
• Communication/teamworking difficulties
• Poor time keeping
• Repeated absences
• Failure to engage with educational processes
• Complaints
• Formal
• Informal
• Do our assessment processes help identify
  struggling doctors?

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Assessments

• Work based assessments (WBA)
• MSF
• Supervisors reports

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Two concerns

• The robustness of the evidence we collect
• The reliability of the judgements

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• The robustness of the evidence we collect
• Tools we use
• Skill and understanding of the assessors
• How trainees use them
• Uncertainty as to whether assessments are
  formative or summative
• The reliability of the judgements
• Structures and skills

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Para 192

• Using validated assessment tools, trained
  assessors from a wide range of health care
  professions will regularly assess foundation
  doctors at work, following a standard assessment
  procedure

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Para 193

• The curriculum also refers to other assessment
  tools that may be used, such as assessing the
  portfolio,video assessment or analysing the
  foundation doctors response to a critical
  incident. These assessment tools may vary
  between foundation schools but in all cases the
  foundation doctor must be told at the start of
  their foundation training exactly what method of
  assessment they will have.

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Northern Deanery Foundation School

• Safer prescribing assessment
• ARCP

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Northern Deanery Foundation School

• Safer prescribing assessment
• ARCP
• Trust based panel review portfolios
• Evidence of engagement with educational process
• Evidence of demonstration of competences
• A sampling process
• Particular reference to supervisors reports and
  MSF
• Time served element

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Northern Deanery Foundation School

• Faculty development
• Educational supervision
• Assessment
• RITA/ARCP panel training
• Doctors with Differing Needs
• Policy development
• Assessment
• Doctors with Differing Needs
• ARCP

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Northern Deanery Foundation School

• A robust system based on our trained educational
  supervisors and faculty and ARCP process?

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Trainee

• eportfolio signed off by educational supervisor
• At ARCP concern expressed and MSF(TAB) and WBA
  assessors were noted to be predominately junior
  staff
• Quality of educational supervision perhaps
  lacking
• MSF repeated with selected assessors
• Further WBA with selected assessors
• Further information came out of the woodwork

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undertaken by grade
Mini CEX DOPS CbD
Consultant 19 7 42
GP 8 2 9
SASG 7 4 8
SpR 44 29 36
S SHO 16 27
Nurse 15
Other 6 14 5
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Assessor training

• 90 trained
• 36 had face to face training
• 48 had read the guidelines

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Assessor training

• 90 trained
• 36 had face to face training
• 48 had read the guidelines
• What constitutes a trained assessor?

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Assessor training

• 90 trained
• 36 had face to face training
• 48 had read the guidelines
• What constitutes a trained assessor?
• To be competent in the skill (demonstrated?)
• To understand assessment and its role in FP
  curriculum
• To be able to give feedback

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• Do we need more precision about what constitutes
  a trained assessor?
• Do we need to be more directive about who can
  undertake assessments?
• Should we explore approved assessors lists
• Do we need to revisit the assessment tools?