e-Portfolio (RCOA): Tips for EdSups/Trainers · the trainee needs to have demonsrated on...
Transcript of e-Portfolio (RCOA): Tips for EdSups/Trainers · the trainee needs to have demonsrated on...
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e-Portfolio (RCOA): Tips for EdSups/Trainers
Dr Patrick Mullen
RCOA DRA Anaesthesia, Mersey
24 May 2013, 22Nov13, updated 6th June 2014
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Impressions from 4 years of e-Port
• Can demonstrate sufficient evidence for ARCP
• Variability in how people using it
problems with sifting/analysis
• ‘Tips’ consistency ease of use/analysis
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Areas to talk about: ‘Tips’
• RCOA resources and feedback re Q/I
• Trainer appraisal
• MDSA website e-Port… resources
• ARCP records
• UOT’s
• PDP’s
• WPBA’s
• Other/Summary
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…RCOA Resources
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…RCOA Resources
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Lost of useful files for training, queries, etc.
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…RCOA Resources
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Areas to talk about: ‘Tips’
• RCOA resources and feedback re Q/I
• Trainer appraisal
• MDSA website e-Port… resources
• ARCP records
• UOT’s
• PDP’s
• WPBA’s
• Other/Summary
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…if trainer clicks on assessment tools, then …
Trainer Appraisal Resources
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Appraisal: You can print a list of number/type of assessments that you have done, by clicking on the
‘Previously approved/rejected’ tab
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Trainer Appraisal: as well as producing this list (or part-printed
for a specific time period), you could also print out one example of each
type of assessment, for your appraisal evidence folder, or look at
this online during your appraisal.
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Deanery Resource
www.merseydeanery.nhs.uk/core-anaesthetic-training/portfolio
Will supplement the existing file about e-Port
that is already there
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Areas to talk about: ‘Tips’
• RCOA resources and feedback re Q/I
• Trainer appraisal
• MDSA website e-Port… resources
• ARCP records
• UOT’s
• PDP’s
• WPBA’s
• Other/Summary
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pre ARCP
• Upload a ‘CV for ARCP’ (into ‘My Details’)
• Upload ‘logbook summary for whatever grade for the year under review at ARCP
• Upload a ‘Unit of Training sessions summary’ (spread sheet, UOT’s on the left, Sessions 1-20 columns on the right, with dates
• (ST3-4’s: Remember that its ‘20 sessions or equivalent’, and that for some UOT’s you can’t really do sessions, e.g. ST3 Cardio-Resp Arrest, Critical Incidents, etc., so focus on Core Clinical Learning Outcomes)
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ARCP Records
This information is updated after ARCP
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Areas to talk about: ‘Tips’
• RCOA resources and feedback re Q/I
• Trainer appraisal
• MDSA website e-Port… resources
• ARCP records
• UOT’s
• PDP’s
• WPBA’s
• Other/Summary
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Units of Training list (UOT’s) in Basic Training curriculum
Next 18 months
First 6 months
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‘Entries’ = 8 types of Assessments, plus the 2
statements; ‘UOT sign-off’ is an Assessment
+ MSF, GCR (group cons report)
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This is an example of a Unit of Training at Basic Training Level: to pass this (competency), the trainee needs to have demonsrated on e-portfolio that the CCLO has been achieved – usually 1 CEX, 1 DOPS, I CbD, plus other supporting evidence (number of sessions/cases, study leave, MSF, GCF, etc.), resulting in an EdSup completion of a ‘UOT sign-off’.
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Example: UOT ‘sign-off’ for an ST6
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Areas to talk about: ‘Tips’
• RCOA resources and feedback re Q/I
• Trainer appraisal
• MDSA website e-Port… resources
• ARCP records
• UOT’s (+ ‘Activities’)
• PDP’s
• WPBA’s
• Other/Summary
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‘Personal Activities’
(as it appears on Trainee eP screen) (Library)
• = ‘Professional Activities’ that are NOT assessments
• Such as S/L, or Meetings, Audits, etc.
• NOT: EdSup reports (=WPBA, ‘Entries’) PB’s in the Gym!
• MSF’s (=WPBA really, so in ‘Entries’)
• Please REFLECT (=Review) on some (or all) of these
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Review = Reflection
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Review = Reflection
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A more detailed Review (Reflection)
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‘Activities’: 1st words & Indexing
• When naming an ‘activity’, choose first word carefully – indexing feature is endemic in e-Portfolio and can be very useful when reviewing ‘items assigned to ARCP’ period
• This means that you should assign items to ARCP regularly, as you go, not last minute.
• E.g. you attend a journal cub ….
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What might you enter this as?
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1st words
• Journal Club
• Journal Club Colorectal
• Using General/Urol/Gynae Journal Club ST3, will enable all the Activities for this UOT to be grouped together by indexing, allowing for easier review by Supervisor(s)
• For some UOT’s, your EdSup will be r/v’ing your e-Port at 22 months into CT1-2, ST3-4, etc ….so quite a few things to sort through potentially.
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(Intermediate Training Curriculum)
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Areas to talk about: ‘Tips’
• RCOA resources and feedback re Q/I
• Trainer appraisal
• MDSA website e-Port… resources
• ARCP records
• UOT’s
• PDP’s
• WPBA’s
• Other/Summary
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PDP = Personal Development ‘PLAN’ This is a consultant style PDP: it has a title, a list of
objectives & actions, a time scale, etc. TITLE
Trainee PDP is structured as Plan (=Title), then Objectives below this (with space for Actions, Resources, Measurement)
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TITLE
Down here to the left is the button called ‘Add Objective’!
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N.B. !!
Your PDP = your Learning Agreement, a list of objectives and actions …for that year. For shorter placements add another objective (specific, e.g. for CardioThor UOT) , still within that ARCP year
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Example PDP (Objectives) for CT1 • Pass ‘Initial Assessment of Competency’
• Complete (≥) 1 AUDIT during CT1 year (Title)
• Pass Primary FRCA MCQ exam
• Annual MSF (+/- ‘Group Consultant Feedback’) to assist ARCP etc.
• Progress *Basis of Anaesthetic Practice (0-6 months)
• Progress with *Basic Anaesthesia (6-24 months)
• Pass ARCP
• (* focus on UOT’s or Core Clinical Learning Outcomes)
Title could be: ‘CT1 (Aintree) 2012-13’
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Example PDP (Objectives) for ST3 • GENERAL DUTIES sub-units: pro-rata progress during
6m placement at … (specify 2-3 to complete, if poss)
• Paediatrics: ~ 50% completion UOT in DGH 6 months
• Complete (≥) 1 AUDIT during ST3 year (Title)
• Pass/progress final FRCA SAQ/MCQ exam
• Annual MSF (+/- ‘Group Consultant Feedback’) to assist ARCP etc.
• Neuro, Paeds, ICM, CardioThor… can be added as individual objectives into an ST3 or ST4 plan
• Pass ARCP Title could be: ‘ST3 2012-13’, but review progress of each objective at the 3 meetings
with your educational supervisor as you rotate
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Actions, Resources, Measurement
• Actions: logbook, WPBA’s, local/regional meetings/courses, e-Learning,
register with RCOA, …
• Resources: S/L, certificates, e-MSF, group consultant feedback, audit dept
• Measurement: you/your EdSup record progress here
• Agree an approach with your EdSup.
• Pad out A R M w’your EdSup (these are your aide memoire) -progress recorded at Mid/End of placement meetings, in ‘Measurement’ box
• Remember S M A R T Objectives/Actions, …
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By ST7, your front PDP page might look like…
• ST3 PDP (COCH 6m/LHCH 2w, LWH 3m, RLUH 3m)
• ST4 PDP (UHA 3m, MGH 6m, WCNN 3m)
• ST5 PDP (….)
• ST6 PDP, etc.
• PDP ‘Plans’ (i.e. Titles) remain editable until they are closed (so you can add LWH 3m etc).
• Make sure your EdSup updates (+/- closes off some/most) your objectives before you leave
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Areas to talk about: ‘Tips’
• RCOA resources and feedback re Q/I
• Trainer appraisal
• MDSA website e-Port… resources
• ARCP records
• UOT’s
• PDP’s
• WPBA’s
• Other/Summary
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WPBA Disparity:
How they are currently seen/used
&
How they could be seen/used
‘Tick Box’
‘Tool Box’
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Is this good or bad ‘Quality’?
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SITUATION
We’ve all seen these type of ‘completed’ or ‘approved’ WPBA’s
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LOTS of variable practice in terms of standards & quality: what is written, where placed, blanks, ….
This narrative ideally better in the ‘Comments’ box below
What competency was being assessed here?
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This area is usually well discussed/documented
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**Discussing/Putting something Specific into these 2 areas/boxes seems to confound trainers and trainees alike**
ALMAT assigned to: Airway (why?), Orthopaedics, Regional, Sedation, Trauma
= A good/bad quality WPBA??
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Direction for further learning going on here,
if a little vague
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CT1 WPBA, completed well – critical evaluation & specific, sensible suggestions going on here, with a novice trainee re an IAC competency. Quality of machine checking would not be sufficient to pass the Primary FRCA, but is about right for a novice 7 weeks in.
Critical evaluation, appropriate to CT1 grade.
= A better quality WPBA?
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= A good quality WPBA?
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Technique
Journals
Drugs
Technique
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Technique
Curriculum
Drugs Journals
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= A good quality WPBA?
Communication
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Good quality WPBA?: Critical evaluation in ‘Improvements’
Sharing of resources/knowledge …..
Also, what’s written likely reflects what happened clinically
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Quality
No Critical evaluation in ‘Improvements’ No sharing of resources/knowledge No direction, no real engagement.
Does what’s written reflect what happened?
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The lack of any trainer comment or evidence of actual assessment is a stumbling block to demonstrating ‘competency’ for a Unit of Training (UOT)
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WPBA Mersey, Review
• < June 2013: E-Port now well up & running
• Trainees/trainers documentation/use of WPBA’s?
• Quality? How to improve?
• Cherry pick lessons/tips for others? - ‘Improvement’ - ‘Further learning and experience’
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Proposal: we could use E-Port as an educational resource for trainers? - To solve/share the ‘I cant think of anything to write (discuss) in these 2 areas’.
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Methods (Mar-Jun2013)
• WPBA period reviewed: 01Aug-31Dec 2012,
• Not feasible for RCOA to ‘pull’ the data
• (23) trainees: 16 CT1-2 475 WPBA’s 7 ST3-4 132 trainers
• All trainees given choice to opt out (N=0)
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Mersey Trainee/Trainers
• 190 Mersey trainees listed on e-Portfolio
• 196 ‘Educational Supervisors’ on e-P
• 152 other ‘Clinical Supervisors’/’Assessors’
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475 WPBA’s
~10% of total during the 5m period
(Brain storming)
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How many WPBA’s per trainee? (over a 5 month period)
(%) CT ST
Median 21 18
IQR 19-25 12-20
Range 11-37 9-37
CT’ trainees x 16, ST’s x 7
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WPBA by type (%)
0
5
10
15
20
25
30
35
40
45
CbD DOPS A-CEX ALMAT
Series1
41
29 28
2
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# UOT’s each WPBA assigned to: CT 1-2 (n=365)
0
5
10
15
20
25
30
35
40
0 1 2 3 >3
% 26
36
19
11
8
Low cross-linkage of WPBA’s Many not assigned (>3 months)
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‘Assessment’ box completed
• Core trainees: 84%
• Specialist trainees: 83%
• = 1:6 blank (3-5 months later)
Recent change: ‘Assessment’ mandatory (‘Satisfactory/Unsatisfactory/Formative Assessment only’
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Interval b/w WPBA’s (days)
0
10
20
30
40
50
60
70
0 50 100 150 200 250 300 350 400
Series1
0
10
20
30
40
50
60
70
80
0 20 40 60 80 100 120
Series1
CT 1-2 (n=365 WPBA)
ST 3-4 (n=110 WPBA)
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?
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What are people writing in: Areas for improvement
Further learning & experience’
(%) Improvement… Further Learning…
Nothing 54 36
Non-specific entry
28 20
Specific entry
18 44
CT’s only (n=365)
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‘Areas for improvement’ ‘Further learning & experience’
(%) Improvement… Further Learning…
Nothing (54) 48 (36) 28
Non-specific (28) 25 (20) 24
Specific (18) 27 (44) 48
(CT’s) in comparison to ST’s
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‘Non-Specific’
• (Nothing written) ++++++
• Continued experience in …
• Further experience in …
• Continued familiarisation with …
• Needs more practice in ….
• Needs experience with real people
• Maintaining skills regularly
• More confidence
• We both need updating on this subject!
• Further consideration & practice
• None identified
• Maintaining these skills regularly
• Further experience of such cases as they arise
• Perform more cases
• Encouragement: - keep up good practice - You will get better - Ability to deal with problems will change as new skills are acquired
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Specific (= Cherry picking)
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e.g.: some trainers are directing trainees to selected websites and other resources, or targeting relevant selected areas for further learning
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How many trainees know the case of Elaine Bromiley?
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www.daysurgeryuk.net
Or Google ‘BADS’
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www.poemsforchildren.co.uk
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Paediatrics
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How many trainees know why the torch is pointing downwards?!
http://www.aagbi.org/
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Lots of cherries!
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Go through the various UOT’s
• Then summarise an approach at the end
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e.g. CT1: Pre-op Assessment
• Communication: lead WHO, ‘material risk’ (n blks)
• Equipment: calibrating FiO2/EtC02 sensors, testing for leaks, AAGBI www.aagbi.org Guidelines:
• Internet: www.euroscore.org, www.sfar.org, www.nrls.npsa.nhs.uk (correct site surgery) ….
• Special circumstances: communication, sight, etc.
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What about what trainees views about WPBA?
• Lit review:
Perspect Med Educ (2013) 2:21-27 Ophthalmology trainees views re obj assessment of OSATS WPBA tool
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Mersey Trainees
Survey about WPBA, March 2014
n=66 responders
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Q:
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Q:
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E-portfolio Disparity:
How it is currently seen/used
&
How it could be seen/used
‘Tick Box’
‘Tool Box’
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May (+/-) be able to help with any queries
…Healthy discontent is a prelude to progress