The Assessment

Assessment in Foundation is based on observation of practice in the workplace, evidence of achievements of each of the foundation professional capabilities and evidence of engagement with the foundation educational process. 

Some terms may not be familiar to a GP trainer. Those areas most relevant to the GP placement are highlighted in bold. Full details are available at

http://www.foundationprogramme.nhs.uk/curriculum/Assessment

Assessments include team assessment behaviours (TABs), the clinical supervisor's (i.e. GP supervisor’s end of placement report) and the educational supervisor's respective end of placement reports and the educational supervisor's end of year report. This will be reviewed in the annual review of competence progression (ARCP).

What will be assessed?

Foundation doctors will only be signed off for progression to the next stage of training when they have demonstrated that their performance meets or exceeds the minimum expected levels of performance required for sign off for each of the 20 foundation professional capabilities. The assessment process is not designed to rank foundation doctors.

Foundation doctors must use their ePortfolio to supply a spread of evidence with appropriate reflection on how their performance meets or exceeds the minimum expected levels of performance required for sign off for each of the 20 foundation professional capabilities. Suitable documentation might include evidence of achievement of some of the 'descriptors' associated with the foundation professional capability. Satisfactory performance will also be judged by engagement with supervised learning events (SLEs) and the resulting personal development. E-learning, generic training and reflective practice should also be appropriately linked to all the curriculum areas.

Supervised Learning Events (SLEs)

SLEs represent an important opportunity for learning and improvement in practice, and are a crucial component of the curriculum. It is the duty of the foundation doctor to demonstrate engagement with this process. This means undertaking an appropriate range and number of SLEs and documenting them in the ePortfolio. SLEs are not formal examinations of knowledge or summative assessments, and should not be treated as such by either the assessor, supervisor or the foundation doctor; but rather, as an opportunity for the foundation doctor to be observed in the clinical setting, to see how they work with others (especially the patient) and to be given feedback with the aim of improving their practice. The clinical supervisor's end of placement report will draw on the evidence of the foundation doctor's engagement in the SLE process. There is the option of nominating a formal placement group, including other practice members in the multiprofessional team to provide specific feedback. Participation in this process, coupled with reflective practice, is a way for the foundation doctor to evaluate how their performance is progressing as they gain experience during the Foundation Programme.

Supervised learning event (Recommended minimum number per four month placement)

• - Direct observation of doctor/patient interaction (3)

• - Mini clinical evaluation exercise (mini-CEX) (at least 2)
  • - This is an evaluation of an observed clinical encounter.
  • - Developmental feedback is provided immediately after the encounter.

• - Direct observation of procedural skills
  • - This is a doctor-patient observed encounter assessed by using a structured check list (optional to supplement mini clinical evaluation exercise).

• - Case-based discussion (2 or more)
  • - This is a structured discussion of real cases in which the F2 doctor has been involved.

• - Developing the clinical teacher (1 or more per year)
  • - This is a tool to aid the development of a foundation doctor's skill in teaching and/or making a presentation.

At the end of each placement the named clinical supervisor and educational supervisor will report whether the foundation doctor's performance is on course to meet or exceed the minimum expected levels of performance required for sign off for each of the 20 foundation professional capabilities at the end of the year of training. These reports will feed into the educational supervisor's end of year report, which will then inform the ARCP review. The annual review of competence progression panel will be able to make reasonable adjustments to reflect individual circumstances.

The assessment tools

The assessment tools used during foundation training can be found below:

Assessments	Frequency
ePortfolio	Contemporaneously
Core procedures	Throughout F1
Team assessment of behaviour (TAB)	Once in first placement of F1 and F2,    optional repetition
Clinical supervisor end of placement report	Once per placement
Educational supervisor end of placement  report	Once per placement
Educational supervisor's end of year report	Once per year

To note:

• - The assessment are designed to be supportive and formative.
• - The foundation doctor can determine the timing of the assessments within each rotation and to some degree can select who does the assessment.
• - It is important that all assessments are completed within the timetable for the Foundation Programme.
• - It is the responsibility of the F2 doctor to arrange their assessments and have their competencies signed off.
• - The assessments do not have to be carried out by the doctor who is the nominated trainer.  A different teacher/trainer should be used for each SLE wherever possible, including at least one at consultant or GP principal level per placement. The educational or clinical supervisor should also be used for an SLE.
• - Teachers/trainers must be sufficiently experienced to teach and assess the topic covered by the SLE and be able to provide meaningful feedback. Typically this will be a doctor with higher specialty training (with variations between specialties), a specialist nurse (band 5 or above) a ward pharmacist or senior allied healthcare professional; this is particularly important with case based discussion.
• - It is important that whoever undertakes the assessment understands the assessment tool they are using.
• - The assessments are not intended to be tutorials, although they will need to have protected time.

How long do the assessments take?

Once clinicians are comfortable with the assessment methods, the trainee requires only 40 minutes per month of assessments. Trainees are responsible for organising their own assessments.