Completing the Examiner Practice Visit Guidance Document


Education Registrars Fellowship Policy framework Guidance documents Completing the Examiner Practice Visit Guidance Document

1. Introduction

This guidance document outlines the purpose and format of the Examiner Practice Visit in the Practice Based Assessment (PBA) Pathway.

2. Definitions

Candidate A medical practitioner enrolled in the Practice Based Assessment Pathway

PBA Practice Based Assessment

RACGP Royal Australian College of General Practitioners

EPV Examiner Practice Visit

AKT Applied Knowledge Test

KFP Key Feature Problems

3. Guidance

All PBA Pathway candidates are required to complete an EPV during the relevant scheduled period as outlined on Timelines and Fees. An RACGP examiner will visit the candidate at their practice at a date and time pre-arranged by the RACGP.

The EPV is a formative assessment process which must be completed prior to commencing the Recorded Consultations. The candidate will not receive a contributory score or a markbut will be provided with feedback on their performance to be used as a preparation tool as they progress to the next stage on the PBA Pathway.

To ensure that candidates receive as much constructive feedback as possible, candidates should follow the guidance outlined below.

3.1 Enrolment process

Candidates will be contacted via e-mail by the PBA team and directed to enrol in the EPV.

Enrolment takes place online via the RACGP website and must be completed before the relevant date outlined on Timelines and Fees.

Candidates will be required to pay the requisite EPV fee, details of which can be found on Timelines and Fees.

3.2 Scheduling of the EPV

Candidates will be contacted by the PBA Team to arrange their EPV. The EPV takes place during the relevant scheduled period as outlined on Timelines and Fees and lasts approximately three and a half hours. The EPV will be scheduled according to examiner availability and, where possible, candidate preferences may be considered.

3.3 Format of the Examiner Practice Visit

The Examiner Practice Visit will be split into four separate segments and will follow the format and timeline outlined below:

Segment

Duration

Example times

  1. Introduction and orientation to the practice

10 minutes

9.00 – 9.10

  1. Observation of 6 patient consultations:
 

Consultation 1

20 minutes

9.10 – 9.30

 

Consultation 2

20 minutes

9.30 – 9.50

 

Consultation 3

20 minutes

9.50 – 10.10

 

Feedback and discussion about consultations

10 minutes

10.10 – 10.20

 

Consultation 4

20 minutes

10.20 – 10.40

 

Consultation 5

20 minutes

10.40 – 11.00

 

Consultation 6

20 minutes

11.00 – 11.20

 

Feedback and discussion about consultations

10 minutes

11.20 – 11.30

  1. Review of 10 patient records

50 minutes

11.30 – 12.20

  1. Summary and conclusion

10 minutes

12.20 – 12.30

 

1. The examiner will be provided with an introduction and orientation to the candidate’s practice.

The purpose of this part of the EPV is to view the candidate’s work setting and to understand the resources, equipment and facilities available to them.

Candidates must ensure that the examiner is provided with the following:

  • brief tour of the practice
  • introduction to key staff
  • review of practice facilities and resources, e.g. treatment room, ECG, etc.
  • overview of allied health professionals and local community services available
  • verification of patient consent process used by practice staff

2. Observation of 6 patient consultations

The examiner will observe the candidate over the course of 6 patient consultations.

The purpose of this part of the EPV is to allow direct observation of the candidate in the practice setting. Direct observation provides the opportunity for the examiner to view how the candidate functions in their own practice and to understand the context of their clinical practice and the way that they serve their local community.

Candidates are required to have scheduled six consultations for the examiner’s visit. The consultations must be scheduled to commence 10 minutes after the EPV start time. 20 minutes must be allowed for each consultation, with a 10 minute break between consultations 3 and 4. Candidates should follow the timeline illustrated in the table above.

Where possible, candidates are encouraged to have a variety of patients booked for consultations to allow the examiner to observe a broad range of presentations and comment on the candidate’s performance in these. However, candidates must not coach patients prior to their EPV by pre-arranging questions or issues to be discussed as this would reduce the examiner’s capacity to provide valuable feedback.

Candidates should follow the steps below to ensure that informed consent is received from patients attending during the EPV:

  1. Candidates must advise their practice reception staff of the clinical session during which an examiner will be in attendance and the reason for this.
  2. At the time of booking an appointment, patients must be informed by practice reception staff that an examiner will be in attendance during their appointment and the reason for this.
  3. On arrival at the practice, the patient must again be advised that an examiner will be in attendance during their appointment and the reason for this.
  4. Patients must sign the Examiner Practice Visit Patient Consent Form before proceeding to their consultation.
  5. In the case of persons under the age of 18 years or children/young people who lack the understanding to consent on their own behalf, the consent of an adult with parental responsibility must be obtained. Where patients are unable to give consent for any other reason, consent may be sought from an appropriate authorised person.
  6. All signed consent forms must be retained within the patient’s medical record.

The Examiner Practice Visit Patient Consent Form will be provided to the candidate at time of enrolment in the Examiner Practice Visit.

Candidates are required to complete a Reflective Learning Tool for each of the six consultations. Candidates must reflect on each of the 6 consultations to determine how adequately they have covered each of the statements on the tool. This will provide candidates with insight into any areas requiring improvement and will familiarise candidates with this tool which is also used in the Recorded Consultations.

After the first 3 consultations, candidates will complete Reflective Learning Tools and will then discuss these with the examiner. The examiner will provide feedback to candidates on their performance and highlight any issues identified in their interactions with their patients. This process is then repeated after the second 3 consultations. The examiner may also provide feedback between consultations should time allow.

If at any time during the EPV the examiner believes that the candidate’s conduct is unsafe or dangerous, the examiner may halt the EPV and intervene in the consultation. If this occurs, the EPV will be suspended and an incident report will be completed by the examiner.

3. Review of 10 patient records

The examiner will review and discuss 10 patient records which have been preselected by the candidate.

The purpose of this part of the EPV is to understand the candidate’s organisational competencies and to engage the candidate in discussion on aspects such as legal, ethical and professional responsibilities. Demonstration of medical knowledge is not the primary focus of this segment.

Candidates are required to identify 10 patient records for the examiner to review. Candidates are encouraged to select a broad range of patient records which deal with complex issues and conditions to ensure that a valuable and interesting discussion can take place. The records should be dated within the 3 months previous to the candidate’s scheduled EPV date

Candidates will be asked a series of questions based on the information uncovered in the records. These may range across the following topics:

  • record keeping
  • clinical assessment
  • clinical management
  • organisational issues
  • medicolegal issues
  • ethical issues.

During the record review, the examiner will provide feedback on the candidate’s responses, highlighting both any areas in which the candidate responded well and in which their response required improvement.

4. Summary and conclusion

Following completion of the above, the examiner will provide a brief summary of the candidate’s overall performance and advise that a full feedback report will be prepared for the candidate.

The EPV will then come to an end and the candidate should escort the examiner out of the practice. The PBA Delivery Team will contact the candidate via telephone following completion of the EPV.

3.4 EPV Feedback Report

Approximately 10 working days after the EPV, the candidate will receive an EPV Feedback Report. The report will mirror evaluation forms completed by the examiner during the EPV and will provide commentary on performance during the visit including:

1. Feedback on observation of 6 patient consultations

The examiner will evaluate the skills and abilities demonstrated by the candidate in the observed consultations and will provide feedback on their performance in the following areas:

  • communication and rapport
  • history taking
  • physical examination
  • problem definition and medical knowledge
  • Investigations and management. 

2. Feedback on review of 10 patient records

The examiner will analyse the knowledge and comprehension by the candidate during the review of 10 patient records and will provide feedback on their performance in the following areas: 

  • organisational competencies
  • legal responsibilities
  • ethical considerations
  • professional standards
  • population health strategies.

The feedback provided on these segments will reveal areas where the candidate has not demonstrated competence which need to be addressed to facilitate their progression on the PBA Pathway. The feedback report will provide direction to the candidate as they prepare to undertake the Recorded Consultations on the PBA Pathway through the identification of aspects of their practice which require improvement.

The candidate should ensure that they read the feedback report thoroughly and are advised to contact the PBA Delivery Team with any questions about the information contained therein.

4. References

Practice Based Assessment Pathway - Entry Policy

Practice Based Assessment Pathway - Examination Eligibility Policy

Practice Based Assessment Pathway - Requirements for Fellowship Policy


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