Workplace-based assessment program
Progressive assessment in the workplace involves observation and assessment of your workplace practice. It allows us to track your progression through training, ensuring you receive support to gain the clinical competencies and skills relevant to your training stage and to progress to Fellowship.
Different people are involved in your education and workplace-based assessment, including:
- your supervisor
- your medical educator
- external assessors
- your program officer.
You’ll receive feedback following each assessment, allowing you to reflect on your progress and plan additional learning opportunities with the support of your supervisor, ME or program officer.
It’s important that you schedule time for assessment, feedback and personal reflection.
Progressive assessment in the workplace comprises different assessment tools.
TIP
We understand that registrars work with different demographics and in certain instances interpreters are crucial to consultations when working with culturally and linguistically diverse populations. Where possible, we encourage registrars to have a consultation in Enflish so that various competencies can be assessed. However, if consultations are not in English an onsite interpreter is required for a WBA.
Overview of assessment tools
The workplace-based assessment comprises:
- early assessment for safety and learning (EASL) suite of tools
- case-based discussion (CBD)
- random case analysis (RCA)
- mini-clinical evaluation exercise (mini-CEX)
- multi-source feedback (MSF)
- clinical audit
You'll be required to complete multiple workplace-based assessments during the FSP, with your supervisor and ME. These will consist of a variety of assessment tools assessing a range of competencies.
Early assessment for safety and learning
The early assessment for safety and learning (EASL) is a suite of tools: but has tools within it as well.
The EASL suite of tools assesses the level of competence of a registrar in early GPT1, identifying areas where closer supervision and guidance may be needed, and if the registrar is able to recognise their limitations and seek help appropriately when required (Figures 4 and 5). Data from the EASL tools inform the development of an appropriate supervision plan tailored to the individual registrar’s level of competence and learning needs in the context of the training practice.
The EASL comprises three components:
- a multiple-choice question (MCQ) assessment with an integrated self-confidence rating
- direct observation of consultations by the supervisor
- daily case discussion and debriefing conducted by the supervisor
Information to guide your supervisor in making this assessment includes:
- completion of the EASL pack
- results from an online multiple-choice questionnaire that you complete
- a workplace-based assessment case review (CBD (two cases) and mini-CEX (four cases)).
These assessments are completed in the first two weeks of GPT1.
You can refer to the early assessment for safety and learning - instructions for registrars for step-by-step instructions and screenshots on how to complete the EASL.
Multiple-choice questionnaire
The EASL multiple-choice questionnaire (MCQ) involves a set of timed online questions. The questions cover various curriculum areas with a focus on patient safety.
You can access the MCQs via gplearning and must complete them in one sitting, as the system will log you out automatically after a period of inactivity.
The MCQs are designed to help identify gaps in applied knowledge, especially in areas that are critical to patient safety. Upon completion of the MCQ, you can view a dashboard summary of your results. This information can assist you and your supervisor identify areas where you require additional support and closer supervision.
Workplace-based assessment - Case review
- CBD - You need to submit two cases in the Assessments and Forms area of the FSP portal. See the case-based discussion section below for more information.
- Mini-CEX - Your supervisor should observe a minimum of four consultations undertaken by you. This may be completed in one session or across multiple sessions, enabling you to make changes based on the feedback provided. If you have remote supervision, these observations will need to occur via video conference such as Zoom or Microsoft Teams. After each observation, your supervisor needs to input their feedback into the FSP portal via the mini-CEX form in the Assessments and Forms section.
Case-based discussion and random case analysis
These tools are 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 any clinical knowledge gaps.
Case-based discussion
For 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 managing 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 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 RACGP 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–CEX involves observation of you performing a consultation. This is delivered remotely via Microsoft Teams by an experienced ME. You don't have to download any software for this.
This style of assessment can either focus on a particular competency area, such as specific clinical skills or professionalism, or it may be managed as a general observation. Find a suitable place in your consulting room to place your device so your ME can view the consultation as if they were in the room with you.
Once completed, your assessor can immediately discuss the consultation with you, providing feedback and ideas for further development. It is encouraged that your supervisor and ME have a brief discussion about your progress at the start or end of a WBA that includes a mini-CEX.
You should talk to your practice manager to ensure bookings are made at no more than two patients per hour. This allows for a standard appointment time of 15 minutes, plus 15 minutes of self-reflection and feedback with your ME. Please make sure reception staff advise patients that a ME will be present during the consult and obtain the patients' consent.
Reception staff must print out a patient consent form on the day of the assessment and hand them to each patient as they arrive. All patients must sign the consent form prior to the start of the consultation. These are to be stored on the patient file at your practice.
You'll participate in eight mini-CEX exercises for each FSP term, except for GPT4. That is four in weeks 1-13, and another four in weeks 14-26, for GPT 1, 2 and 3.
Multi-source feedback
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.
Your MSF pack will be posted directly to your training site (if you work in more than one training site, it will be posted to the training site where you work the most hours) from the company Client Focused Evaluation Program (CFEP) Surveys. The pack you receive in the mail is only for your patients to complete. You, as well as your nominated colleagues, will receive login details via email to complete a report through the CFEP portal.
You'll need to:
- gather 30 patient's feedback and return the pack to CFEP in an enclosed self-addressed envelope (do not forward these to the RACGP)
- nominate 12 colleagues to provide feedback via the CFEP portal. Remember, you're able to draw on anyone you have professionally interacted with in the past 12 months
- use the CFEP portal to complete a self-reflection.
Patients are surveyed using an interpersonal skills questionnaire. 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.
You'll complete one MSF assessment during your general practice training, this will be during GPT2.
CFEP will compile the data and a final survey report will be uploaded to your FSP portal Documentation section in the last few weeks of GPT3. You and your ME should discuss this at your next scheduled progress meeting.