Promoting Excellence in Family Medicine Educational Supervision & Find Your Way Around in the E-portfolio Dr Jane Mamelok RCGP WPBA Clinical Lead.

Promoting Excellence in Family Medicine

Educational Supervision & Find Your Way Around in the E-

portfolio

Dr Jane MamelokRCGP WPBA Clinical Lead

Workplace Based Assessment

“The evaluation of a doctor’s progress over time, in their performance in those areas of professional practice best tested in the workplace”

FORMATIVE

Summative judgment made by panels informed by evidence from WPBA

Miller’s Pyramid

KnowsKnowledg

eAKT

Shows How

Knows How

Performance

Competence

CSA

CSA

DoesActionWPB

A

Coverage by assessmentsCurriculum WPBA CSA AKT

Primary care management      

Person centred care     

Specific Problem-solving skills

Comprehensive approach      

Community orientation     

Holistic approach     

Contextual Aspects     

Attitudinal Aspects      

Scientific Aspects   

Psychomotor skills

RELATIONSHIP DIAGNOSTICS

MANAGEMENT

Professionalism

Maintaining Performance, Learning & Teaching

Primary Care Administration

& IMT

Community Orientation

Maintaining an Ethical Approach to Practice

Fitness to Practise

Data Gathering & Interpretation

Clinical Management

Managing Medical Complexity

Making a Diagnosis / Making decisions

Communication & Consulting Skills

Working with Colleagues & in Teams

Practising Holistically

The potential of linking WPBA & the learning portfolio.

WPBA assesses performance in the workplace over the entire training programme against 12 defined competencies. The portfolio gathers the information and offers the opportunity for reflection and formative feedback.Links assessment to learning outcomes and continuing professional development.

Clinical Supervision

Clinical supervision describes the framework for regular, structured encounters reflecting on casework in the context of the post or specialty in which the health professionals are working and aims to identify areas of best practice and developmental needs. It has an important clinical governance function.

Educational supervision

Educational supervision is organised supervision taking place in the context of a training programme, it is aimed more to act as an umbrella to guide the trainee through the training programme than assessing and discussing individual cases (which is in the domain of the clinical supervisor).

Gold Guide Requirements

Clinical supervision Each trainee should have a named clinical supervisor for each placement, usually a senior doctor, who is responsible for ensuring that appropriate clinical supervision of the trainee’s day-to-day clinical performance occurs at all times, with regular feedback.

Gold Guide Requirements

Educational supervisionEducational supervisors are responsible for overseeing training to ensure that trainees are making the necessary clinical and educational progress. Where possible, it is desirable for trainees to have the same educational supervisor for the whole of their training programme or for stages of training (e.g. the early years or more advanced years of training).

What makes a good educational supervisor ?

Senior educator with an understanding of training programme, assessments and employment issues.

Good listener offering supportive challenge.

Can give constructive feedback

Professionalism, recognises the conflicting roles, sets boundaries etc.

The role of the ES in GP specialty training.

This can be summarised as providing an overarching umbrella of guidance helping the trainee get the best out of their programme and navigating their way through it.However, the ES assesses the rate of progress and development of competence contributing to a summative judgement.

Varied roles of the Educational Supervisor

Guidance and support with performance appraisal

Learning needs assessment, empowering and facilitating the learner.

Conduit and network function

Appraiser and counsellor

Coaching and career counselling

Guardian role

So you are supervising a GP specialty trainee, what do you need to do?

Identify you learner, ST1 ST2 or ST3.

Arrange an early meeting to set boundaries, frequency of meetings etc.

The ES needs to be able to navigate the e-portfolio proficiently.

Review the evidence.

Give formative feedback and define PDP at the staged reviews.

Reviewing the evidence

1. Check assessment schedule.

2. Review the self assessment ratings.

3. Review PDP objectives if follow on review.

4. Review competency and curriculum coverage

5. Purposeful sampling of the learning log – descriptive v reflective.

6. Look at CSR is there evidence to support their judgement?

7. Hone in on some of the COTs and CBDs

The Review page e-portfolio

Check the assessment schedule

Review the PDP

Review curriculum & competency coverage and self rating scales

Sample the learning log

Review the Clinical Supervisors report

Questions for debate

How much is enough?

How much evidence do you need to make a judgement?

What do we mean by competence?

How much evidence is enough?

The evidence gathered from WPBA builds up a “picture” of the

competent GP.

Defence of evidence

Have we got this right yet?Medical Schools using portfolios for undergraduates have a portfolio interview which allows the trainees to defend the evidence and this informs the portfolio assessment decision.Is there a role for portfolio viva?

Is that final ARCP panelsOr RCGP oral examiners?

Assessment decision

Portfolios are criticised because they depend on subjective judgements that are unreliable.Schuwirth (2002) argues that they can be reliable if but the “judgements must be collected in a way that samples through possible sources of bias” – sampling professional behaviours on multiple occasions and multiple assessors

Key steps for development

Define a portfolio framework but no so restrictive as to trivialise the evidence .Encourage reflection – can be learned.Educator and assessor training are crucial.

Need to understand competency frameworkDefine competenceAchieve acceptable inter rater reliability

Encourage Balanced portfoliosRobust WPBA and portfolio standards for portfolio assessment – defend the JPC decision.Developments in e-portfolio functionality must match the work on standards and competency framework.

Summary

The educational supervisor has a key role in directing and supporting the training programme for each learner.There are useful analogies between the role of the appraiser and the appraisal portfolio and the similar role for educational supervisors.Training and support for trainees and educators are key.The e-portfolio must be user friendly and functionality appropriate to purpose.Your feedback (to WPBA group) is important. Email WPBA Lead [email protected]