Abstract
Last month’s Crammer’s Corner provided an introduction to Workplace-based Assessment (WPBA), covering requirements, standards and how to create an effective learning-log entry. This month we move on to cover the recent changes to the Educational Supervisors Review (ESR) and generation of the Personal Development Plan (PDP), considering why the changes were made and some top tips for this new format.
Changes to the ESR format and generation of the PDP
Background
The ESR is a record of a meeting between the GP trainee and the Educational Supervisor (ES), which takes place every 6 months (regardless of whether the trainee works full-time or part-time). This meeting reviews the evidence collected by the trainee against the 13 areas of professional competence. At this meeting a learning plan is agreed for the next review period, enabling the trainee to tailor their learning for their next rotation and giving support to the trainee in progress towards being ‘competent for licensing’ at the end of training. Prior to the recent changes, this learning plan required both trainee and ES to write specific plans for each of the 13 competence areas.
Three to five of the action plans, written by the ES, were then selected to form PDP entries for the trainee’s next review period. It was still expected that the trainee would produce additional PDP entries related to learning needs that they identified during their clinical posts. The ESR, once submitted by the ES, was only released for all to view once the trainee agreed it and signed it off.
Problems with the previous ESR and PDP
The WPBA group identified several problems with the previous ESR and PDP, which prompted the recent changes. The previous ESR involved a lot of work with both the trainee and ES, each needing to generate 13 action plans and as a result the quality of the actions was often reduced. Progress against these action plans was not then being formally reviewed, as the action plans were too long and not valued by the trainee or ES. There was thus no clear, succinct summary of the specific areas requiring the attention of the trainee for the next review or for the post certificate of completion of training (CCT) appraisal.
Furthermore, when the action plans were converted to PDP entries they were focused purely on the competencies and did not address curriculum-related learning needs. The entries, once generated, were not editable in the PDP format, and as a result did not present as ‘SMART’ (specific, measurable, attainable, realistic and timely). Therefore, trainees often found these PDP entries less meaningful and not personal to them. The PDP objectives were often not met and the PDPs did not align with the post-CCT appraisal process. The PDPs were devalued and there was reduced trainee ownership and disengagement with the process.
On completion of the ESR, the trainee needed to sign off the ESR prior to the Annual Review of Competence Progression (ARCP). If the trainee disagreed with the review it could not be signed off and the ARCP would be delayed. Also, the issues leading to disagreement could not be commented on by the trainee.
New developments
In an attempt to address these problems, the ESR and PDP were updated in November 2016. This update was released to all, but was not necessarily visible on the ePortfolio because many trainees were already in the review period for a January 2017 ESR. However, the updated ESR and PDP will now be visible to all and will apply to the summer ESRs.
Change to actions before next review or post-CCT appraisal
The number of trainee ‘suggested actions’ and trainer ‘agreed actions’ has reduced to a minimum of just three. These actions cover the main areas that the trainee needs to focus on before the next review across all competency statements. The ES is able to add two further actions if appropriate. Those trainees not achieving competence at the expected rate need to have additional actions specific to their particular needs. If the trainee has written SMART actions, the ES does not need to take any action. The agreed actions (maximum five) are summarised in a single table against the competency headings, producing a succinct set of actions for them to use. This table appears at the end of the review and is a useful summary document available for reference throughout the next review period.
Agreed actions from the previous review appear on the final page of the ESR and need to be reviewed by the trainee and ES as part of the ESR. Progress can be reviewed and if not achieved a box appears for comment.
In summary, these changes confer the following benefits:
A reduced burden of assessment The easy generation of more focused, succinct and meaningful actions for the next review The easy review of actions created by the trainee and ES (detailed under competency headings in both current and previous review periods) The facility to easily refer back to these actions and comment upon if not achieved.
Changes to the PDP generated during ESR
The updated PDP and ESR now require the trainee to propose at least one, and up to three, PDP entries at the time they complete their self-rating and before they can release this for the ES to view, if they have not already created any in that period. Any PDP entries written in the current review period will automatically appear for review. The proposed PDP entries can then be discussed at the ESR meeting, with the ES giving feedback and help editing, to make SMART, if required. Once agreed, the PDP entries become part of the trainees on-going PDP.
The trainee is expected to add additional entries to demonstrate awareness of learning needs and a plan to address these within the PDP section of the ePortfolio.
In summary, these changes confer the following benefits:
Trainees are encouraged to focus on their proposed PDPs before the review PDPs and agreed actions will be ‘owned’ by the trainee SMART PDP objectives can easily be encouraged PDPs will be more achievable in the focused and SMART format Subsequent discussion at the ESR can be more meaningful and feedback to the trainee can then enable editing and improvement of the proposed PDP The changes allow for a broader range of PDP entries focused on any aspect of training and tailored to the trainees’ needs PDP generation will align with the post CCT appraisal process
Changes to sign off and release
Once completed, the ESR is now signed off by the ES and at this point it will be released and viewable by all who have access to the ePortfolio. The trainee is no longer required to accept it before it is released. Instead, the trainee is asked whether they agree with the ESR (Yes/No). If the answer is ‘no’ a ‘comments’ box will appear for the trainee to respond and explain why they disagree with the ES report.
In summary, these changes confer the following benefits:
Trainees now have an opportunity to comment on the competed ESR, but the completed ESR is still visible on the ePortfolio even if the trainee does not accept/agree it The ESR can be released more quickly avoiding delays at ARCP
Top tips for trainees on the PDP and ESR
Think about achievable learning objectives for the next post and produce SMART PDPs that address learning needs Look back at the summary of ‘agreed actions’ regularly and focus your log entries and assessments accordingly Focus on quality rather than quantity in your learning-log entries and think about both the competencies you are demonstrating and the learning you show in different curriculum areas Look at your PDP regularly and use it to direct your learning Review progress with your PDP and document progress regularly, especially before each review Review learning-log entries and identify areas of the curriculum and competencies that require more and better evidence of learning
Things to avoid
Only looking at the agreed actions in preparation for or at your ESR Only reviewing or looking at PDP entries during the ESR meeting PDP entries not in the SMART format Not regularly reviewing evidence throughout the 6-month period
The MRCGP is always evolving, so for the most up-to-date information please consult the RCGP website.