Guide to Intern Assessment Processes for Supervisors

• This PPT has been developed with the support of CPMEC and primarily authored by Debbie Paltridge, Alison Jones and Carmen Crawford.

• We would like to acknowledge the reviewers of the material for their valued contribution’s

Outline1. What are the requirements for Intern assessment in 2014?2. Why do we assess interns?3. What is your role in intern assessment?4. How does general registration relate to internship?5. What is the AMC’s role in internship?6. What happens at the end of intern year Certification Process?7. What do you need to know about the nationally available Assessment

Form?8. How do the assessment processes link to the Australian Curriculum

Framework for Junior Doctors (ACF)?9. What are the next steps to support implementation?

What are the requirements for intern assessment in 2014?

What are the requirements for intern assessment in 2014?

• Refer to new national registration standard: http://www.medicalboard.gov.au/Registration-Standards.aspx

• New requirements:– Standard requiring assessment against intern

outcome statements (2014 transition)– National form for certifying interns’ completion

(mandatory from 2014)– Term assessment form (resource available from

2014)

Why do we assess interns?

Why do we assess interns?• Patient safety– To assist in decisions made about delegation and

independence of practice• Interns are provisionally registered and require

supervision and education• Clinical oversight– To improve workload management

• To assist in directing intern learning and clinical experience

• To make decisions about intern progression

What is your role in intern assessment?

What is your role in intern assessment?

• Providing a snapshot of information on the intern’s performance– Gathering information from people who have seen

the intern perform– Direct observation of the intern in the workplace

• Providing timely feedback to promote development of the intern’s knowledge, skills and attitudes

What is your role in intern assessment?

• Identifying an intern with performance issues– Assisting in remediation of those issues– Recognising when issues need to be escalated and referred to DCT/DPET/MEO/DMS

How does registration relate to internship?

How does registration relate to internship?

• Interns are granted provisional registration by the Medical Board of Australia (MBA) to complete the intern year

• The intern year is a period of supervised clinical practice. – At least 47 weeks of supervised practice in accredited

terms (core terms of medicine (10 weeks)/surgery (10 weeks)/emergency medical care (8 weeks) and other non core accredited terms)

How does registration relate to internship?

• After satisfactory completion of the intern year, interns can apply to the MBA for general registration– The Medical Board will consider the totality of advice in

deciding whether to grant general registration.

– An intern who has performed marginally or unsatisfactorily in a specified term but who has demonstrated ‘significant’ progress with evidence of remediation may be deemed to have metthe standard expected for general registrationby the end of the year.

What is the AMC’s role in internship?

AMC role in internship

• Accredits medical training programs for the Medical Board of Australia

• Developed standards, guidelines and forms for a national internship framework

• Developed a nationally consistent assessment process based on:– Intern Outcome Statements (aligned with the graduate outcome

statements for medical schools)– Medical Board of Australia Requirements for Certification and Sign off,

and– A nationally available Term Assessment Form linked to the Intern

Outcome Statements

• AMC Prevocational Standards Accreditation Committee oversees national intern standards

What happens at the end of intern year certification process?

What happens at the end of intern year certification process?

• DMS/DCT/DPET considers all term reports– Can be assisted by an Assessment Review Group (if

needed)

• Written confirmation whether the intern has:– Satisfactory term supervisor reports – An overall satisfactory rating– Determination of any additional remediation

required e.g. additional time in core terms

• Assessment Review Group:– To assist with more complex decisions on

remediation – Chaired by a senior clinician with experience in the

education and training of interns and include; employer representatives and relevant educators.

– Should have clear and transparent procedures for deciding on any course of action and for resolving disputes and appeals.

What is the end of year Certification process?

So what do you need to know about the Nationally Available Assessment Form

Before you start

• You need to be aware that the form is only a tool to facilitate assessment

• Assessment requires you to:– Be familiar with the assessment requirements– Determine how you are going to gather

information to inform your decisions– Ensure the intern is aware of the assessment

processes you will be undertaking

The Assessment Form

• Based on the Intern Outcome Statements• Uses a 5 point scale with descriptors– Research shows improved reliability of this

approach particularly in large groups of assessors– Descriptors will guide you to provide an authentic

rating of the trainee’s performance– Three descriptors have been developed for each

Intern Outcome Statement (ratings 1, 3 and 5) • Not observed option

• Example: 2.2 .Communicate clearly, sensitively and effectively with patients, their family/carers, doctors and other health professionals.

Rating Descriptor

5 Communicates effectively in routine and difficult situations: actively listens, demonstrates appropriate language for the audience (patients, families or other health professionals) and checks for understanding

4 Performance level between 5 and 3

3 Communicates effectively in routine situations, but some difficulty in adapting communication to deal with challenging situations

2 Performance level between 3 and 1

1 Rarely communicates effectively: does not actively listen, cannot adapt language to the audience and rarely checks for understanding

The Assessment Form

• After you have rated each of the intern outcome statements you will be required to make a Global rating of their performance on this term

• In making this rating you need to consider the their ability to:– practise safely; – work with increased levels of responsibility; – apply existing knowledge and skills and learn new

knowledge and skills as required

The Assessment Form

The Assessment Discussion• Provide regular feedback throughout the term and

consolidate this at your mid and end of term discussions• Ensure you and the intern are clear about what is being

assessed and why• Ask the intern what they need feedback on (encourage

them to refer to the ACF capabilities) • Consider the intern’s self assessment ratings where

completed• Discuss your assessment decisions, drawing on the

descriptors

What if you have identified some areas that the intern needs to work on?

• Identification of performance issues needs to occur as early as possible within the term.

• Where the intern is rated at a 2 or below and a 3 in some instances an Improving Performance Action Plan (IPAP) is required.

• This should be developed in consultation with the DCT/DPET and the intern

AMC Intern Outcome Statement (e.g. Domain 1 Statement 1.2)

Issues related to specific outcomes statement

Actions/Tasks

Responsibility Timeframe Review Date

Supervisor comments on the outcome of remediation:

• Located at the end of the Assessment form

The IPAP

How do the assessment processes link to the ACF?

How do the assessment processes link to the ACF?

• The ACF is currently used to:– Guide formal education programs provided to

PGY 1s and PGY 2s– Outline the term experiences– Assist interns’ self reflection on their experiences

– “what have I learnt on this term?”

How do the assessment processes link to the ACF?

• The Intern Outcome statements have been mapped to the ACF domains

• The ACF provides more detailed information to describe the breadth of learning experiences the intern may have

• The ACF is a good tool to use in your assessment discussions

Next steps to support implementation

What are the next steps to support implementation?

• Familiarise yourself with the form• Ask your DCT or MEO any questions you may

have about the process• Ensure your interns are comfortable with the

process• Provide feedback on the process to your MEOs

to inform any future developments

Any Questions?

Summary

• Implementation of any new process takes some time for everyone to become familiar with the changes

• Intern assessment is everyone’s responsibility • The assessment form is one part of the

process• Supervisors play a crucial role in the

development of interns