Trainer’s WorkshopTrainer’s Workshop

Thursday July 5Thursday July 5thth

Oak Tree SurgeryOak Tree Surgery

AgendaAgenda

Clinical Skills AssessmentClinical Skills Assessment Communication Observation ToolCommunication Observation Tool To Do List/Action PlanTo Do List/Action Plan Registrars in difficultyRegistrars in difficulty Educational supervisorsEducational supervisors CPD PaymentsCPD Payments AOBAOB

– Date of next meetingDate of next meeting

CSACSA Assessment centreAssessment centre 12 stations + – 10 minutes12 stations + – 10 minutes Developed OSCE formatDeveloped OSCE format

– Simulated surgeries + clinical skillsSimulated surgeries + clinical skills 3 diets per year?3 diets per year? 200/300 cases developed per year200/300 cases developed per year 3000 candidates / year3000 candidates / year No. attempts up to candidateNo. attempts up to candidate >3 = remedial help>3 = remedial help Taken after at least 6 months ST & within 18 Taken after at least 6 months ST & within 18

months of completion months of completion

Case SelectionCase Selection

Every case is based on a specific Every case is based on a specific statement from the GP curriculumstatement from the GP curriculum

Pair of examiners design casePair of examiners design case Cell leader reviews case and Cell leader reviews case and

suggests refinementsuggests refinement ““Hanging committee” review caseHanging committee” review case Case is pilotedCase is piloted Case is accepted for use in Case is accepted for use in

assessmentassessment

GP Curriculum CompetenciesGP Curriculum Competencies 11 Communication & Consultation skillsCommunication & Consultation skills 22 Practising holisticallyPractising holistically 33 Data gatheringData gathering 44 Making a diagnosis / making decisionsMaking a diagnosis / making decisions 55 Clinical managementClinical management 66 Managing medical complexityManaging medical complexity 77 Primary care administration & IMTPrimary care administration & IMT 88 Working with colleaguesWorking with colleagues 99 Community orientationCommunity orientation 1010 Maintaining performance, learning & Maintaining performance, learning &

teachingteaching 1111 Maintaining an ethical approach to practiceMaintaining an ethical approach to practice 1212 Fitness to practiceFitness to practice

Case AssessmentCase Assessment

CSA uses 3 CSA uses 3 domainsdomains

Data-gathering,Data-gathering,

technical, and technical, and assessment skillsassessment skills

Clinical Clinical management skillsmanagement skills

Interpersonal skillsInterpersonal skills

The AssessmentThe Assessment

3 domains3 domains– +ve & -ve indicators+ve & -ve indicators

GradingGrading– Clear Pass (CP)Clear Pass (CP)– Marginal pass (MP)Marginal pass (MP)– Marginal fail (MF)Marginal fail (MF)– Clear fail (CF)Clear fail (CF)

For each domainFor each domainGlobal decisionGlobal decision

FeedbackFeedback

Consultation Observation ToolConsultation Observation Tool

13 part assessment schedule13 part assessment schedule Cobbles together old MRCGP video Cobbles together old MRCGP video

marking schedule with Summative marking schedule with Summative Assessment video marking scheduleAssessment video marking schedule

COTCOT1.1. … … seen to encourage patient’s contribution at appropriate points in consultationseen to encourage patient’s contribution at appropriate points in consultation2.2. … … seen to respond t cues that lead to deeper understanding of problemseen to respond t cues that lead to deeper understanding of problem3.3. … … uses appropriate psychological and social information to place complaint in uses appropriate psychological and social information to place complaint in

contextcontext4.4. … … explores patient’s health understandingexplores patient’s health understanding5.5. … … obtains sufficient information to include or exclude relevant significant obtains sufficient information to include or exclude relevant significant

conditionsconditions6.6. The physical/mental examination chosen is likely to confirm or disprove The physical/mental examination chosen is likely to confirm or disprove

hypotheses, or is designed to address patient’s concernhypotheses, or is designed to address patient’s concern7.7. … … appears to make a clinically appropriate working diagnosisappears to make a clinically appropriate working diagnosis8.8. … … explains the problem or diagnosis in appropriate languageexplains the problem or diagnosis in appropriate language9.9. … … specifically seeks to confirm the patient’s understanding of the diagnosisspecifically seeks to confirm the patient’s understanding of the diagnosis10.10. The management plan is appropriate for the working diagnosis, reflecting a good The management plan is appropriate for the working diagnosis, reflecting a good

understanding of modern accepted medical practiceunderstanding of modern accepted medical practice11.11. The patient is given the opportunity to be involved in significant management The patient is given the opportunity to be involved in significant management

decisionsdecisions12.12. Makes effective use of resourcesMakes effective use of resources13.13. … … specifies the conditions and interval for follow-up or reviewspecifies the conditions and interval for follow-up or review

Familiarise yourself with the e-Familiarise yourself with the e-portfolioportfolio

https://www.nhseportfolios.org/NHSDots/ePortfolio/login_rcghttps://www.nhseportfolios.org/NHSDots/ePortfolio/login_rcgp.aspp.asp

Re-orientate tutorials to fit in with GP Re-orientate tutorials to fit in with GP Curriculum?Curriculum?

Devise Action Plan for the training Devise Action Plan for the training year year

To Do List/Action PlanTo Do List/Action Plan

Possible action planPossible action plan August – orientation to practice, IT, de-hospitalisationAugust – orientation to practice, IT, de-hospitalisation September – focus on developing consulting skillsSeptember – focus on developing consulting skills October – first CBD (2 cases) and COT (2 video October – first CBD (2 cases) and COT (2 video

consultations)consultations) November – second CBD and COTNovember – second CBD and COT December – third CBD and COT, introduce 10 minute December – third CBD and COT, introduce 10 minute

appointmentsappointments January – moving towards more 10 minute appointmentsJanuary – moving towards more 10 minute appointments February – MSFFebruary – MSF March – fourth CBD and COTMarch – fourth CBD and COT April – MSF, PSQApril – MSF, PSQ May - fifth CBD and COTMay - fifth CBD and COT June – sixth CBD and COT, enhanced trainer’s report, June – sixth CBD and COT, enhanced trainer’s report,

appraisal Form 4, OOHappraisal Form 4, OOH