Workplace-based assessment program
The workplace-based assessment program forms part of your FSP and involves observation and assessment of your practice in your own workplace via a range of formats. It allows us to track your progression through training, ensuring you receive the support that you need to gain the clinical competencies and skills relevant to your stage of training and to progress to Fellowship.
A number of different people are involved in supporting your education and workplace-based assessment, including:
- your supervisor(s)
- your medical educator
- external assessors/clinical teaching visitors
- your training coordinator.
You’ll receive feedback following each of your assessments to allow you to reflect on your progress and plan additional learning opportunities with the support of your supervisor, ME or training coordinator.
It’s important that you schedule time for assessment, feedback and personal reflection.
Overview of assessment tools
The workplace-based assessment program comprises:
- early assessment for safety and learning suite of tools
- workplace-based assessments
- oversight by the Progression Review Committee.
Early assessment for safety and learning
We understand that registrars enter their first general practice placement with varying levels of experience and clinical competency. Registrars come from diverse backgrounds, and some may be unfamiliar with working in Australian general practice. An early assessment for safety and learning (EASL) ensures that the supervision you receive is matched to your learning needs.
Information to guide your supervisor in making this assessment includes an online applied knowledge multiple-choice question assessment that you complete, regular case review, clinical case analysis (two cases) and direct observations of your consultations (four cases). These assessments are generally done in the first two weeks of GPT1.
Clinical case analysis
Clinical case analysis (CCA) is a hybrid assessment format comprising review of clinical notes or case reports and oral questioning. CCA assessment tools include case-based discussions and random case analysis.
The CCA is designed to assess your clinical reasoning, management and decision-making skills using clinical cases that you’ve managed. Feedback is generally provided immediately after each session to support learning and reflection.
Your assessor will use a structured discussion format for the assessment. Targeted questions will allow you to demonstrate your competency across specified curriculum and syllabus areas. The assessor will explore in detail any issues relating to the case to identify if you have any clinical knowledge gaps. You’ll be expected to participate in four CCA sessions each six months in GPT 1, 2, and 3.
For case-based discussions (CBD), you’ll be asked to select a recent clinical case to present to the assessor, including providing clinical notes, relevant investigations or results, and details of referrals or preventive healthcare plans. You’ll present cases that you’ve been primarily responsible for and that represent a medium level of complexity, where clinical reasoning may be complicated by uncertainty and/or where decision-making requires consideration of multiple issues.
You might highlight aspects of the case for discussion, depending on your self-identified learning needs. Sometimes an assessor may request a case with a specific area of focus, particularly if it’s been identified that you need support in that area.
Random case analysis
In random case analysis (RCA), the assessor will randomly select a case from your consultation records to discuss. They’ll ask you to think about the case from different perspectives and discuss these through the lens of the curriculum and syllabus, in particular, the five domains of general practice. The development of your clinical reasoning will be explored through consideration of how a change in one of four contextual influences – the doctor, the patient, the problem and the system – changes the case.
RCA is helpful to ensure you explore cases you may not usually see in your day-to-day practice.
Mini-clinical evaluation exercise
A mini-clinical evaluation exercise (mini–CEX) is an assessment that involves observation of you performing a consultation. This style of assessment can either focus on a particular competency area, such as professionalism, or specific clinical skills; it may be managed as a general observation. Once completed, your assessor can immediately discuss the consultation with you, providing feedback and ideas for further development, if necessary. You’ll participate in eight mini–CEX exercises for each FSP term, except for the GPT4.
Multi-source feedback (MSF) provides you with feedback from both patients and colleagues and asks you to self-evaluate your skills, particularly in the areas of communication and professionalism. When you receive your feedback report, you’ll be asked to reflect on the details with your ME.
Patients are surveyed using an interpersonal skills questionnaire. Data is collected from a minimum of 30 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 focuses on your professionalism and workplace behaviours. Perceptions are collected about areas such as working relationships, competence, and professional development.
You’ll generally complete only one MSF assessment during your general practice training, and that will be in GPT2, with feedback given in GPT3.
End-term appraisals are completed by your supervisor. These reports include details about your competency at the current stage of training and enable tracking of your progression through training, as well as providing an opportunity for you to talk with your supervisor about your learning.