Practice Experience Program Specialist (PEP SP) Participant Handbook - Substantially Comparable Stream

Training program

Workplace-based assessments

Workplace-based assessments

Overview

During your training program, you’ll be required to satisfactorily complete a series of workplace-based assessments (WBAs).

WBAs provide a comprehensive framework for evaluating your competence in areas of practice best assessed in the context of the workplace. Specific WBA competencies have been developed and mapped to the core skills of the RACGP Curriculum for Australian General Practice to enable assessment in the workplace. They include:

  • communication and consultation skills,
  • clinical information-gathering and interpretation,
  • making a diagnosis, decision-making and reasoning,
  • clinical management and therapeutic reasoning,
  • partnering with the patient, family and community to improve health through disease prevention and health promotion,
  • professionalism, and
  • general practice systems and regulatory requirements.

For each competency, the expected standard is set at the point of admission to Fellowship, i.e. the point at which you are ready to demonstrate competence for unsupervised practice in Australia.

In the PEP SP, WBAs comprise the following components:


The purpose of the multi-source feedback (MSF) is to obtain feedback from colleagues and patients. The MSF is a well-recognised, valid and reliable method of assessing interpersonal and professional behaviour, development and clinical skills.

The MSF is delivered by Client Focused Evaluations Program (CFEP) Surveys and comprises three components:

  • The Doctor’s Interpersonal Skills Questionnaire (DISQ). The DISQ is a 40 paper-based survey to be completed by a random selection of your patients. Data is collected from patients following their consultations with you. The survey explores patient perceptions about your behaviours, such as listening skills, clarity of explanations, respect for the patient and involvement of the patient in decision-making, as well as the patient’s confidence in your ability.
  • The Colleague Feedback Evaluation Tool (CFET). In the CFET, 15 colleagues nominated by you will be asked to complete an online survey. The colleague feedback evaluation focuses on your professionalism and workplace behaviours. Perceptions are collected about areas such as working relationships, competence and professional development.
  • The self-assessment questionnaire. This questionnaire provides an insight as to how you view yourself and compares these results with the feedback provided.

Upon completion and submission of all three components, you will receive a report from CFEP Surveys. You will be required to complete a mandatory reflection activity comprising an interview with your ME and a written self-reflective exercise.

 Important!
If you completed an MSF within one year prior to commencing PEP SP, you may not need to complete a new one provided your existing MSF survey is approved by your ME.

You will get access to the MSF when you commence work in your approved practice. We recommend you start the MSF process as soon as possible as it can take some time to complete and needs to be finalised prior to the end of your training program.


After you have spent at least three calendar months working in your approved practice, you’ll be required to complete a clinical assessment. The clinical assessment will be conducted online via videoconferencing and be made up of two components: direct observations and clinical case analyses (CCAs).

Your ME will let you know once you can start scheduling the direct observations and CCAs. At that point, the PEP SP administration team will give you access to the WBA booking calendar so you can book the WBA sessions at dates and times that suit you best. For any scheduling questions, you may contact the PEP SP administration team at pepspecialistadmin@racgp.org.au


During a direct observation, the assessor will observe you while you are consulting with patients in your practice. Direct observations will be conducted virtually via videoconferencing. To records their feedback, the assessor will use a standardised and widely used assessment tool: the Mini-Clinical Evaluation Exercise (Mini-CEX). The criteria considered during the observations can be found in the mini-CEX rubric and mini-CEX rating form.

Things to consider in preparation for the direct observation:

The date and time of the assessment will be booked in advance, so make sure that you are ready for the start of the consultation and ensure you have two devices capable of internet connection (e.g. office computer, plus a laptop or tablet).
Ensure reception is aware of the assessment and arranges your appointment book appropriately. Schedule 30 minutes for each patient to allow for observation and feedback.
Ensure there is some patient-free time at the start of your assessment. This allows time for you and the assessor to discuss the outline for the session.
Preferably keep consultation time with the patient to under 20 minutes, as the effective use of time is one of the performance criteria.
Remember to advise the practice that some bookings may not work well for assessment – examples include cervical screening tests, routine childhood immunisations, removal of sutures and ear syringing.
Patients need to consent to the presence of another doctor during the consultation. Patients should provide verbal consent while booking the appointment, sign a consent form when they arrive for the appointment and confirm their understanding that another doctor will be present when you call them from the waiting room. You should record in the patient’s notes the presence of an observer and their name.
Introduce the assessor to the patient and briefly explain their role. Words such as ‘Dr X is here to assist me with my professional development’ can be useful.
The assessor might ask you questions related to the case in order to probe your reasoning. They might also ask to review any written material related to the case, such as a referral letter that you wrote or the notes that you made.
Be prepared to reflect on your own performance and discuss this with the assessor.

Requirements

You must complete three direct observations by the end of your training program. Each direct observation must target a different learning need as identified during your induction.


Clinical case analysis (CCA) is a hybrid assessment format comprising review of clinical notes or case reports and/or oral questioning. It is designed to assess your clinical reasoning, management and decision-making skills using clinical cases that you’ve managed.

CCAs will be conducted virtually using videoconferencing. The ME will use a structured discussion format for the assessment. Targeted questions will allow you to demonstrate your competency across specified areas of the RACGP Curriculum and syllabus. The ME will explore in detail any issues relating to the case to identify if you have any clinical knowledge gaps.

CCA assessment tools include the two options below:

Case-based discussions (CBD) In a CBD, the participant presents a recent clinical case to the assessor, providing de-identified clinical notes, relevant investigations or results, and details of referrals or preventive healthcare plans.
The case must be one that the participant has been primarily responsible for and that is of a medium level of complexity; for example, where clinical reasoning is complicated by uncertainty or where decision making requires multiple issues to be considered. An assessor may request a case be presented that focuses on a specific area, particularly one in which the participant has been identified as needing further support.

As the assessor works through the case with the participant, they may pose questions from varying perspectives to explore clinical reasoning further. The participant may also highlight aspects of the chosen case for discussion, depending on their self-identified learning needs.

Participants must submit their CBD cases on the RACGP Case Submission Template at least two weeks prior to the assessment. The quality of the written submission forms part of the assessment and you may be requested to resubmit the case if it does not convey information sufficiently.
Random case analyses (RCA) For an RCA, the assessor randomly selects a case from the participant’s consultation records to discuss or use a submitted case to explore additional curriculum domains. The RCA method may uncover gaps in knowledge and skills that a participant may not have identified.

An RCA is generally conducted through the lens of the five domains of general practice of the curriculum and syllabus, and explores the development of clinical reasoning by considering changes to four contextual influences: the doctor, the patient, the problem and the system. By proposing hypothetical scenarios through ‘what if’ questions, unidentified learning needs may be uncovered.

The RCA requires little preparation but allows the assessor to choose the case on the day of your direct observation.

Requirements

You must complete three CCAs by the end of your training program, including:

  • one CCA with an Aboriginal and Torres Strait Islander focus, and
  • one CCA targeted at a learning need identified during your induction.   


The direct observations and CCAs will be conducted by three independent assessors, separate to your mentor ME, as described in Figure 4.

Figure 4: Clinical assessment first attempt – assessor model

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