In Bradford, we're trying to develop an ARCP process that enables us to easily identify the struggling trainee but is light touch for the trainee who is progressing well. In light of this, we've develop two ARCP checklist forms (available from the blue downloads box above) - a brief one for the trainee who is doing okay and a more detailed one for those with concerns.

 

Sometimes it is difficult to make a general picture of a trainee when looking at individual assessments alone (like COTs and CBDs). That is why looking at the reports (both Clinical and Educational Supervisors'), the MSF and PSQ is important - they help 'glue' all the bits of evidence together to provide a more all-rounded and additional insights.

 

The ultimate purpose of ARCP panels is to determine whether trainees are progressing well towards compentence. We're not asking you to look for excellence. All we're asking you is whether there is 'good enough' evidence of satisfactory progression. Don't lose sight of this.

 

 

• The next Deanery ARCP preparation course
• Please contact Sofya to book to go on. Sofya.Loren@bradfordhospitals.nhs.uk
• If you are new to doing ARCP panels, you MUST book to go on. This course is for both lay and doctor assessors.

 

 

Dear Panel member...

Please go through all the documents in the blue downloads box above in order and bit by bit. You will feel overloaded and exhausted if you attempt to do these all at the eleventh hour.

 

The documents under ARCP Process and Organisation simply summarise the ARCP process in Bradford. The purpose of these documents is to ensure we all understand how the system works in Bradford and what is expected from each of us. You can read these documents at any time before your ARCP panel date - the earlier, the better.

 

Next are some ARCP help files which will be particularly helpful to those who are new to doing ARCP panels. All new ARCP lay panel members are expected to do the 'ARCP training package for Lay Assessors'. Again, please make some protected time to do this and don't leave it til the last minute - it's quite a detailed training package that will take a bit of time to complete.

 

The most important documents are those listed under ARCP forms. These checklists will help add structure to your 'ARCP assessment' of the trainee. One of them is brief and the other detailed. If you think the Eductational Supervisor's Report (ESR) is reliable, then use the brief ARCP assessment form. If it's not, then you'll have to do a mini-ES process yourself and that's when the second more detailed form will come in handy. Those who are completely new to doing ARCP panels, I would recommend that you use the detailed one on one of your allocated trainees to help you get your bearings right.

 

I know some of you don’t like using forms, BUT these forms will make your lives a lot easier. They provide the necessary structure and guidance that inexperience panel members need to help align them to the more experienced ones. So, please use them and in time, as you become familiar with the whole thing, you'll be glad you used them. A unified approach will lead to a more reliable, valid and easier to determine ARCP outcome.

 

- All ARCP panel members MUST USE ONE OF THESE TWO ARCP CHECKLIST FORMS FOR EACH OF THEIR TRAINEES. It's important that we're all approaching the ARCP process in the same way (singing from the same hymn sheet).

 

- When you have finished assessing your trainee, give them a global COLOUR score. GREEN if they are clearly okay. RED if the are clearly not okay and definately need referring to a deanery panel. And finally AMBER if you're not quite sure and would like to seek the opinion of the rest of the panel. It's the AMBER trainees that will mostly absorb panel time. Panels should be able to whizz through those in the GREEN and to a lesser extent, those in the RED.

 

- The final page of both ARCP checklists is dedicated to giving feedback to the Edcuational Supervisor. How can we improve next year’s quality of ES reports if we don’t provide feedback now to help them better themselves? Improving the quality of ES reports will make future ARCP panels so much easier. Therefore, will all panel members please fill this in for each Educational Supervisor AND remember to be specific (in other words, don't just say something was good, say what was good about it).

 

- Finally, there is a feedback form on the ARCP process itself. We will ask you to do this after the actual panel session. This will help us make the process even more efficient and generally better the next time around.

 

 

• Dear Panel Chair...

• Different panel chairs can decide to run their panel sessions in different ways but the following gives you some idea of how I plan to run mine. It worked very well for me the last time and this ‘formula’ may make things easier for you too.  The idea behind this set up is to ensure we don't run out of time, especially for the difficult ones.

• 
  At the start of the session, once everyone has arrived, we will introduce ourselves.
• I will then go through a PowerPoint to
• a) basically make sure my panel members are all on the same wavelength
• b) lay down some ground rules
• c) how I plan to 'run the show' (and to forgive me for moving people on)
• d) how I expect them to present (so that it is concise yet comprehensive enough)

• On the table there will be 3 sheets of A4 labelled GREEN, AMBER and RED.   Before we start talking about trainees, I will ask panel members to write down each of their allocated trainees on one of the three forms.  
  ·       GREEN = they're clearly okay.  
  ·       AMBER = they're not sure but would like an opinion from the rest of the panel. 
  ·       RED = they're clearly NOT okay and definitely need referring to deanery panel.

• 
  I will start the discussions by presenting one of my straight forward (GREEN) ones. The purpose of me starting is to

• (a) illustrate how to present it in a smooth and time efficient way,

• (b) to allow panel members to ask questions to clarify and

• (c) to get one 'in the bag'.

• 
  After that first one, we will then go for the AMBER trainees first. These are the ones most likely to need and absorb time so it is important we give them their due. After the AMBERs, we'll move to REDs and then GREENs. Should we run out of time, then at least we will have devoted our attention to where it is needed the most. We should be able to whizz through the rest.

 

When the ARCP panel session discussions are over, the administrator will do two things.

1. Hand out feedback forms on the ARCP panel process itself.

2. Collect the feedback forms for the Educational Supervisors (which panel members will have done at home). It is important that when the others have left, that you, as ARCP chair, with your administrator review and remove any unsuitable comments (comments that are too harsh or may offend). The administrator will then amalgamate all the feedback for a particular supervisor onto one form so that they don't feel too overwhelemed when it is sent to them.

I hope you all think this is a reasonable way forwards.

• Any other suggestions - email me on rameshmehay@googlemail.com

Ramesh Mehay

 

 

• Dear ARCP administrator
• In Bradford, there are now going to be two panel tiers. The first tier panels will look at all the trainees and sieve out which trainees are clearly okay and which need further discussion. Those that are not clearly okay will be sent to the second panel tier whose job it is to decide whether the trainees need a referral to the Deanery panel or whether things can be sorted out locally.

Dates of first and second tier ARCP panels 2011

The dates of the first tier ARCP panels are: ·

9th June 2011– Nick as Chair (Thursday) @ xxxxxx ·

10th June 2011– Lucy as Chair (Friday) @ Bradford Royal Infirmary 10 am ·

13th June 2011 – Maggie (Monday) @ Bradford Royal Infirmary 10 am ·

14th June 2011 – Ramesh (Tuesday) @ Ashcroft Surgery 10.30am

The date of the second tier ARCP panel is: · Thursday 16th June 2011 @ Ashcroft Surgery 10 am · It will consist of Ramesh Mehay (in a Trainer capacity), Maggie and Nick (as TPD roles).

 

· We need you to recruit one lay panel member (? a Practice Manager) For each first tier ARCP panel:

· There needs to be 3 people – a panel chair (the TPD listed above), a trainer and a lay person.

· Please can you recruit a trainer and lay person for each of our panels. When allocating trainees to each panel, please remember: Use the ARCP panel-trainee allocation form downloadable from the blue box above.

· The ones who need an ARCP panel are those that are moving up an ST grade (i.e. moving from ST1 to ST2 or ST2 to ST3) or are due for CCT (i.e. are ST3s who will be leaving our scheme).

· Please allocate them evenly amongst the four groups - we should have roughly the same work load. This doesn’t just mean making sure we all have the same numbers. It also means that we all have roughly the same number of ST1s, ST2s and ST3s.

· Within each group, again, allocate the trainees evenly to the three panel members. It’s particularly important to allocate those who are due for CCT evenly as these can take a bit more time to assess than the rest.

· When allocating, PLEASE make sure the trainee has not been under the direct clinical or educational supervision of any of the three panel members: this is incredibly important. With us using Practice Managers as lay panel members, this is going to make allocations significantly more difficult.

· If you have any issues with allocating a trainee, please liaise with Nick Price.

 

Please send an email to trainees at the beginning of May, something along the lines of...

Dear trainees, Most of you will be undergoing an ARCP panel review next month. In order to facilitate this process, please can you make sure you do the following as soon as possible (it's incredibly important because it will determine whether you go onto the next ST stage):

- Upload your COT, CEX and COT mapping forms

- Upload them to their learning log and use an appropriate title like 'COT mapping form'.

- Upload your statement of leave and HDR attendance- again, upload them to your learning log and use an appropriate title like 'Statement of Leave' or 'HDR attendance'.

- Make sure you tidy up and complete anything that needs sorting in your e-portfolios - especially your PDPs.

 

There is a useful document called 'ES preparation checklist'' You can find it under the downloads section of the Educational Supervision section of Bradford VTS website.

• Feedback
• When the ARCP panel is over, we need you to do two things
• 1. Hand out feedback forms on the ARCP panel process itself. The ARCP feedback form can be downloaded from the blue downloads box above and will need printing off before the panel process.
• 2. Collect the feedback forms on the Educational Supervisors which the ARCP panel members will have done at home. Make sure you sit down with the lead ARCP chair who will review and remove any unsuitable comments (comments that are too harsh or may offend). Then you will need to collate all the feedback for a particular person onto one form so that they don't feel too overwhelmed when receiving it.
• Other things
• Don’t forget about organising the food for these dates. Just needs to cater for 3-4 people. Perhaps something basic and not too costly? I hope this will make life and things a lot easier this year with respect to ARCP panels.

•  

• 
  Educational Supervision for ARCP panel newbies

   

  Click on a grey box to open or close it.

•  

  What is Educational Supervision?

  * a process of regular meetings between teacher and learner with support for the benefit of the learner

   

  * a process which allows the demonstration of strengths and revealing of difficulties so that these may be helped to be put right within the framework of the objectives set at the start of the programme.

   

  * a process that is confidential (except in defined circumstances), primarily educational and developmental, and designed to help the individual to progress

   

  * a positive process to give someone feedback on their performance, to chart their continuing progress and to identify developmental needs.

   

  * a forward-looking process essential for the developmental and educational planning needs of an individual

   

  All these definitions are basically saying the meetings are there to help the learner by giving them feedback, keeping them on track for their training and helping them to develop in those areas where there is an identified need.

   

  What It Is and What It Isn't

  

   

  In assessment the trainee tries to hide what they are bad at; in educational supervision they should be comfortable about displaying it

   

  The Difference Between an Educational Supervisor and a Clinical Supervisor?

   

  Throughout training, the GP trainee will have one educational supervisor and several clinical supervisors. They will have regular reviews with both. However, don't confuse the two. Each aims to do different things as illustrated in the table below.

   

  Educational Supervisor	Clinical Supervisor
  Looks at the overall educational programme (ie the whole training scheme)	Looks at the clinical needs determined by your performance in your current post.
  Helps ensure the trainee gets appropriate training and experience in an integrated way throughout training and make them aware of educational opportunities for their needs in terms of the training programme as a whole	Ensures that an individual doctor’s timetable allows attendance at formal teaching sessions, is appropriate for his/her learning needs and that there is a correct balance between training and service in the placement.
  Helps the trainee keep on track for MRCGP and is where the multisource feedback is reviewed
  Involves a review of the trainee's assessments and feedback	Carries out assessments that will be reviewed in educational supervision. The clinical supervisor will supervise clinical activity ensuring that the trainee only performs tasks without supervision that they are competent so to do. In essence, clinical supervisors oversee the day-to-day work of the trainee.
  Results in an educational supervisor’s report. The Educational supervisor will ultimately be responsible for signing off the trainee at the end of each ST year before progressing to the next. This needs to be recorded in the trainee's eportfolio.	Results in a clinical supervisor’s report. Clinical supervisors will sign off workplace-based assessments, and write an end-of-placement clinical supervisor's report to be recorded in the trainee’s eportfolio.
  The trainee usually has one supervisor throughout the entire scheme - usually a programme director or trainer	The clinical supervisor changes every time the trainee changes post Usually a consultant from the department they are working in
  In Yorkshire, you are meant to have 1-2 educational supervision meetings per post.	Clinical supervisors are expected to hold formative meetings with their trainee at the beginning, middle and end of their placement.
  	They will be the trainee’s initial point of contact in issues relating to the specific post.

   

   

  The ES Meetings - what's the overall purpose?

  The meeting is for the trainee's benefit and aims to:

   

  1. ensure that they are on track for GP training

   

  2. help them with educational planning - looking at progress and developing an educational personal development plan (PDP)

   

  3. pick up on any difficulties they may be experiencing - whether personal or with the post so that they can iron these out and get the trainee back on track for training

   

  4. to communicate to others (eg programme directors) whether or not the trainee is doing okay

   

   

  Sorts of things covered in supervision meetings?

  The supervision meetings will contain summative and formative elements. It is NOT about one or the other - it's about both.

   

  

   

  * To able to carry out effective supervision meetings tailored to the trainee's individual needs, the supervisor will need access to (and thus review) their e-portfolio. It is important to review the trainee's workplace-based evidence as recorded in the e-portfolio to ensure that they are doing the right number at the right times and making effective progress.

   

  * They will also check to see whether the trainee has done the AKT or CSA and if not, when they plan to take them.

   

  • * The MSF/PSQ and the clinical supervisors report are felt to be quite good discriminators of how a trainee is doing.

   

  * All of this will generate a collaborative "agreed learning plan" (through an appraisal type process).

   

  * Educational supervision is particularly useful for identifying trainees with difficulties so things can be put in place to help training go more smoothly and successfully; for this to work requires honesty and openess from both sides. We hope the educational supervisor will create a safe climate in which this will happen.

   

   

  What Happens After the Meetings?

  * the trainee and the supervisor MUST fill in the e-portfolio's educational supervision report.

   

  * This report will highlight any difficulties - either personal, educational or with the post. Educational supervision is not about disciplinary procedures but more about helping the trainee overcome or see them through the difficulties.

   

  What standards should be used?

  In the early stages of training it is unlikely that the GPStR will be able to provide evidence for the readiness to practise. The structured evidence, considered against the competence framework, will highlight the areas where the GPStR is doing well and those areas where more learning and support is needed. Thus each of the reviews will lead to a learning plan designed to enable the GPStR to collect more evidence of competence and to build up a richer picture of readiness for practice.

   

  The standard against which the GPStR is judged is always the level of competence expected of a doctor who is certified to practise independently as a general practitioner.

   

  This standard is used throughout the three years of training. This means that in the first two years of training the GPStR is being judged against the standard they should have reached at the end of training. Inevitably there will be less evidence from the application of the WPBA tools in the first two years of training, and more developmental needs will be identified. This is what the assessment system is designed to do, so that further training experiences can be directed toward the developmental needs of GPStRs.

   

  So, it's okay for a ST1 or ST2 trainee to have many areas that "need further development"; they just need to work on them with time. The GPStR must show competence in all twelve competence areas by the end of year 3.

  The GPStR must show competence in all twelve competence areas by the end of year 3.
  Trainers are expected to use their personal experience as a GP to judge whether the evidence for each competence area and the totality of evidence indicate that the GPStR is ready for independent practice.

   

   

  How much evidence of each competence is enough?

  Assessment of competences is about making a qualitative judgement not a quantitative one. We would expect that at the end of ST3 the GPStR will have several sets of evidence in each competence area, collected from a range of settings and through different tools.

   

  However, the only requirement is that there is enough evidence to enable the trainer to feel confident that the GPStR is competent to practise. Each portfolio will look slightly different, but it should provide a rich picture of competence built up over three years. The “ticks” in the ePortfolio are simply a way of keeping a shared, transparent and systematic record of evidence.

   

  I'm not very familiar with this Naturally Occuring Evidence (NOE) stuff...

   

  I think the Yorkshire-Humber Deanery website covers it very well. Click here to go there now.

   

  However, there's a lot of good stuff on our website too. Click here: www.bradfordvts.co.uk/MRCGP/NOE.htm

   

   

   

  ARCP panels - FAQs

   

  How does ARCP and Educational Supervision fit in with each other?

   

  There is a panel called the ARCP (Annual Review of Competency Progression) that meets every June to review the trainees progress and hopefully sign them off so that they can go on to the next ST stage or, if they're in their final year, get their certificate of completed training (CCT).

   

  * The ARCP panel is a formal deanery sub-school of General Practice.

   

  

   

  Tell Me About the ARCP Panel

   

  In any round of ARCP panels, each trainee who is due a panel has one panel with one outcome.  The panel is a two stage process, beginning with a local (scheme) panel and concluding with a central (deanery) panel which takes place a couple of weeks after the round of local panels has concluded.  Each of the three areas (Leeds, NEYNL and Sheffield) hold central panels in their respective offices.  Trainees who are given a satisfactory panel outcome by the local panel, or are out of programme, do not need to be further considered by the deanery panel.

   

  * For the ARCP panel to be able to sign the trainee off, they have to have their educational and clinical supervisor's reports uploaded.

   

  What are local panels?
  Local panels will be chaired by programme directors with the rest of the panel made up in accordance with the Gold Guide.  Deanery input is offered to local panels for as long as local panels wish it (different schemes are at different levels of readiness to run local panels and deanery input is to offer support, advice and consistency as necessary).
   
  Local panels review the ePortfolios of GPSTs; face to face meetings do not happen at local panels.
   
  There are four possible conclusions a local panel can come to with four different actions:-
   
  1. Satisfactory (either for progression or CCT).  The panel awards the outcome and the panel chair completes and submits the outcome.
  3. Mainly satisfactory with some minor issues (eg some missing evidence).  The panel chair gives feedback to the GPST and a timescale to remedy the issues.  The panel chair then reviews the ePortfolio after such time has passed and gives a satisfactory outcome and completes and submits the outcome or, if the issues have not been remedied, refers the GPST to the second stage of the panel, ie: the central (Deanery) panel (see bullet 4 below).
  5. The trainee is out of programme.  The out of programme outcome is given and the date of the next panel is carefully chosen so that the returning GPST has time to acquire the evidence for satisfactory progression.
  7. The ePortfolio is thought to be unsatisfactory.  The panel chair coordinates the information on the ARCP form.   The panel chair sends a written report to their central (Deanery) panel detailing the reasons why the local panel was unable to give a satisfactory outcome.

   

  And Deanery panels?

  All GPSTs where there is any doubt about the outcome are reviewed at the second stage central panel.  The trainee is told they will have a central panel and they have the opportunity to submit evidence of mitigating circumstances prior to the panel.  The decision for a face to face or ePortfolio review is made on a case by case basis.  The dates of central panels to be advertised in advance and trainees informed that they must make themselves available if required.

   

  It is envisaged that some unsatisfactory ePortfolios will become satisfactory by the time of the central panel.  If so, then a satisfactory outcome may be awarded, but there should be consideration of entering an educator’s note about why the local panel was unable to award a satisfactory outcome.

   

  Most unsatisfactory ePortfolios will be unsatisfactory because of incomplete evidence (either quantitative or qualitative) or the need to develop specific competences, and if so they should be given the appropriate outcome and the reasons detailed on the ARCP form.  Neither of these outcomes requires extension of training, although it is a possible future option if the issues aren’t resolved.

   

  If an ePortfolio is so flawed, or the trainee is in such difficulty, that they will not complete WPBA within the time (usually 3 years) then the trainee should be given an outcome of inadequate progress and additional training required, or released from training.  It should be made clear that it is not the gift of the panel to offer such additional training; that decision rests with the deanery and the Director of Postgraduate GP Education.

   

  The deanery panel sets the date of the next ARCP panel and this goes back to local panels as described above.

   

  Some notes from a recent ARCP panel

  Here are some important points we felt it might be worth passing on after having been to a recent ARCP panel meeting:

   

  What the curriculum headings mean:
  Teaching, mentoring and clinical supervision means the teaching etc which the trainee has done, NOT the educational etc experiences which they have received
  Management in General Practice means organisational management, NOT clinical management of patients
   
  DOPS
  There’s no point recording previous experience which hasn’t been directly observed. It’s essential to get the e portfolio entries for the compulsory DOPS put in by whoever observed the procedure.  If this isn’t done, PMETB will bounce your e portfolio when it’s submitted for CCT at the end of ST3.  Also, the procedure has to be on a patient and not, for example, in a skills lab.
   
  CSA preparation
  The RCGP representative who was at the panel strongly recommended that some COTs are done not on video but with directly observed consultations, i e the trainer sits in with the trainee.  This will help trainees get used to consulting with someone watching.  Also, it means that a range of normal consultations are observed by the trainer, not just the good ones which trainees tend to select for COTs
   
  OOH
  The educational reason for OOH is for trainees to acquire the relevant competencies.  Simply recording the number of sessions worked doesn’t provide evidence of this.   Trainees should make sure that the paper OOH workbook sheets are completed by their supervisor, scanned and uploaded to the e portfolio as evidence of the educational outcomes of the session, as well as making sure that they’ve done the required number of sessions
  
  Signature on educational contract
  Apparently this keeps disappearing so the Educational Supervisor may need to renew it every time the trainee changes post