Workplace based assessment (WPBA) is defined as the evaluation of a doctor’s progress over time in their performance in those areas of professional practice best tested in the workplace. It is a process through which evidence of competence in independent practice is gathered in a structured and systematic framework. Evidence is collected over all three years of training. The evidence is recorded in a web-based portfolio (the e-portfolio) and used to inform six monthly reviews and, at the end of training, to make a holistic, qualitative judgement about the readiness of the GPST for independent practice.
WPBA is a developmental process. It will therefore provide feedback to the GPST and drive learning. It will also indicate where a doctor is in difficulty. It is learner led: the GPST decides which evidence to put forward for review and validation by the trainer. It is delivered locally by deaneries.
What does WPBA involve?
WPBA consists of a framework of 13 areas of professional capabilities (formerly known as competencies) click here for levels of expectation for each capability GP Capabilities Detailed Descriptors
The use of each tool serves as an episode of evidence collection. The WPBA tools ensure the evidence is collected in the same way for each GPST, and promote consistency among trainers and across deaneries.
The use of the tools does not involve pass/fail assessments; the judgement may be one of insufficient or inadequate evidence, particularly in the early stages of training, but this simply points to the need for further training. At regular points during training all the evidence available from the trainee is reviewed and a judgement is made about progress through each area of professional competence.
WPBA involves making qualitative not quantitative judgements. As the GPST proceeds through training it would normally be expected that evidence of competence is demonstrated and the degree of readiness to practise is built up. The picture becomes clearer as more evidence is gathered.
Educational Supervisor Review (RCGP Guidance)
Frequency of ESR
An ESR is conducted every six calendar months, whether you’re training full-time or not. Reviews are carried out even if they do not coincide exactly with the end of posts. This ensures regular feedback and engagement with the evidence in the Trainee ePortfolio, and means that the ARCP panel has a recent ESR to inform their decision making.
Review meetings usually take between one and two hours, followed by a write-up in the ePortfolio.
Capability progression in ESR
For the six-monthly reviews, you’ll first conduct a self-assessment of your progress on the 13 capabilities. You’re then be assessed by the educational supervisor.
Quality of evidence is more important than quantity. In the early stages of training, it’s unlikely that you’ll be able to provide evidence of readiness to practise. But the review will form the basis of a learning plan, highlighting where you’re doing well and where more support is needed.
By the end of ST3, the educational supervisor will be looking to establish fitness to practise through several sets of evidence in each capability area, collected from a range of settings and through different tools. Each portfolio will look slightly different, but it should provide a rich picture built up over three years.
The WPBA tools are:
Clinical Examination and Procedural Skills (CEPS) and guidance on intimate examination
Case Based Discussion Tool
Prescribing Assessment RCGP pilot phase for ST3s (Aug 2019) replaces 2 CBDs in ST3 year
Consultation Observation Tool (COT) and Audio COTs (1-3 audio COTs required as part of the number of total COTs in ST3)
Multi Source Feedback ST1 (both 6 month posts) and ST3 (both 6 month periods)
Patient Satisfaction Questionnaire PSQ (in GP posts only)
Clinical Evaluation Exercise Mini CEX (hospital post only)
Clinical Supervisors Report (at the end of each post)
Out of Hours and Urgent, Unscheduled and Emergency Care – Trainee Guidance
Click link for local forms
One of the RCGP Curriculum Clinical Management core capabilities is to provide general clinical care to patients of all ages and backgrounds. This includes the provision of urgent, unscheduled and emergency care.
The current guidance document Supporting the Educational Attainment of Urgent and Unscheduled Care Capabilities in General Practice Specialty Training states that the “key capabilities pertinent to working in the unscheduled / urgent care setting have been articulated by the RCGP as including: the delivery of safe patient centred care, effective communication utilising the range of modalities encountered in delivering this care, maintaining continuity for patients and colleagues including co-ordination across services and enabling patient self-efficacy.” In addition, “the generalist role of the GP should be maintained and that newly qualified GPs have the requisite capabilities to work across the full spectrum of primary care as delivered in all four nations of the UK”.
The mechanism of delivery of Out of Hours (OOH) services varies across the four countries of the UK. GP trainees have different contractual arrangements in each of the four countries. How does this affect what the GP trainee is required to demonstrate in terms of capabilities; and record in terms of the ePortfolio?
The RCGP curriculum and the supporting guidance document on urgent and unscheduled care do not specify the number of hours needed to meet the required Clinical Management core capability, nor a specific number of log entries. However, it is stated that “whilst it is recognised that knowledge and skills needed to develop urgent and unscheduled capabilities may be gained “in hours” and in varying secondary / community / urgent care services there remain particular features more likely encountered in a primary care urgent care setting that require specific educational focus. Thus, to gain experience of, for example, working in isolation and with relative lack of supporting services GP specialty trainees will need significant opportunities to develop these capabilities in Out of Hours Services / primary care based urgent /unscheduled care provider organisations.”
It is the responsibility of the individual trainee, in discussion with their Educational Supervisor, to ensure that they have sufficient experience across a range of settings including OOH services to be able to meet the required capabilities described above. It is the responsibility of the Educational Supervisor to ensure that they are satisfied that these capabilities have been met before signing off the final Educational Supervisor Report (ESR).
It should be noted that in some areas of the UK, GP trainees will have a contractual requirement to complete a specified number of OOH sessions / hours. Fulfilling this contractual requirement should not be seen as equivalent to meeting the curriculum capabilities. Trainees will still need signed off as competent in these capabilities by their Educational Supervisor.
What does this mean for the ePortfolio and the Educational Supervisor Report (ESR)? Experiences of and learning from urgent and unscheduled care should be recorded in the ePortfiolio to demonstrate progression and achievement of capabilities, as for all other areas of the curriculum. Significant OOH experiences, where learning has been demonstrated, should be recorded as a Clinical Case Review. There is no longer a requirement for a log entry for every OOH session. However, trainees may wish to note relevant cases seen in the OOH setting for discussion with their Educational Supervisor.
There will no longer be a requirement for the Educational Supervisor to sign a statement that the trainee “has met [their] out of hours session requirements”. The capabilities required to provide urgent, unscheduled and emergency care will be assessed as part of the overall ESR.
However, for those trainees who have a contractual requirement to complete OOH sessions / hours, a spreadsheet will need to be completed and uploaded to the ePortfolio under the Supporting Documentation heading so that it can be reviewed before the completion of training. An example spreadsheet is available on the Work Place Based Assessment pages of the RCGP website.
Click here for more information via the RCGP website
Educational Supervisors Review
You meet your educational supervisor every six months to review the evidence you’ve collected against the 13 areas of professional capability. You’ll need to complete a self-assessment prior to the meeting.
There are minimum standards setting out the amount of evidence that you need to collect, and guidelines on how often each WPBA tool should be used to ensure there’s sufficient evidence at the point of each six-monthly review.
As part of the meeting, you’ll agree a learning plan covering the next review period. If the evidence you’ve collected is inadequate or insufficient, you and your supervisor may decide to use the WPBA tools more frequently.
More information on the Educational Supervisors Review (ESR)
WPBA minimum evidence requirements: full time training
The minimum evidence requirements described below are based on a standard three-year speciality training programme, with 18 months of hospital posts and 18 months in general practice.
GP Speciality training year one (ST1)
|minimum requirements prior to 12 month review||6 x mini-CEX (if in secondary care) / COT (if in primary care)
6 x CbD
2 x MSF (each with a minimum of 5 replies from clinicians plus 5 non-clinicians if in primary care)
1 x PSQ (if in primary care)
CEPS as appropriate
clinical supervisors report from each hospital post
GP Speciality Training Year Two (ST2)
|minimum requirements prior to 24 month review||6 x mini-CEX (if in secondary care) / COT (if in primary care)
6 x CbD
1 x PSQ (if in primary care and not already completed in ST1)
CEPS as appropriate
clinical supervisors report from each hospital post
GP Speciality training year three (ST3)
|minimum requirements prior to 36 month review||12 x CbD
12 x COT
2 x MSF (each with 5 clinicians and 5 non-clinicians)
1 x PSQ