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Work Place Based Assessment (WPBA)

WPBA is defined as "the evaluation of a doctor’s progress over time in their performance in those areas of professional practice best tested in the workplace”. Its aim is to try and link teaching, learning and assessment. More Detail on the Workplace-based Assessment.

Each defined area of competency should be demonstrated when the learner is ready to do so and it is anticipated that there will be a development of skills and progression in each competency over the whole 3 years duration of WPBA.

For each competency, the trainee will be assessed and graded as “showing insufficient evidence” or progressing to “needs further development” or a passing “competent” but could still develop further to an “Excellent”. Remember that each competency is being assessed against the "standard expected by the end of the ST3 year". This means that "needs further development" is very likely throughout the ST1 and ST2 years and will frequently be "showing insufficient evidence" as several areas applicable to primary care cannot be assessed during a secondary care assessment. Many AITs are concerned when they start ST3 that their competencies are once again assessed as "needs further development" but this should be anticipated as "normal" for most of us.

The assessors are locally based with individual Clinical Supervisors (Hospital Consultant or GP Trainer) and a 6 monthly Educational Supervisor review.

Evidence will be gathered about the learners’ development. The RCGP expects AITs to show evidence from a variety of assessors using all the tools more frequently than the bare minimum number required. A range of methods are used including;

Case Based discussion (CBD) – effectively a structured oral interview designed to assess professional judgment.

Consultation Observation Tool (COT) – this can be either direct observation of a doctor consulting or by using the familiar tool of video.

Clinical Evaluation Exercise (Mini-CEX) – this is a 15 minute snapshot of a doctor/patient interaction formally assessed with immediate 5 minute feedback. This effectively is the secondary care based equivalent of a COT.

Direct Observation of Procedural Skills (DOPS) – a 20 minute formal assessment of procedural skills essential to the provision of good clinical care. In General Practice the relevant technical skills might include cervical smears, breast examination, vaginal and rectal examination and minor surgical skills. If these have not been demonstrated early on in the ST1 & ST2 years, it will be necessary to do so in the final Registrar year.

Apart from the above local assessment tools, there will be external tools too;

Multi-Source Feedback (MSF) – web based feedback assessing clinical ability and professional behaviour. Feedback will be from at least 5 clinical and 5 non-clinical staff on four separate occasions - twice in ST1 & ST2 year 1 (ST1) and twice in ST3.

Patient Satisfaction Questionnaire (PSQ) – 30 consecutive consultations will need formal written patient feedback in particular looking at consultation skills and empathy scores.

Cervical Screening

Guidance on training for sample takers

 

Introduction

The standards for cervical screening sample taker training are set out in the NHS Cancer Screening Programmes publication number 23 (April 2006). The minimum training requirements for sample takers are that they should have attended:

 

·    basic training in cervical cytology,

·    liquid based cytology (LBC) training and

·    update training every three years

NHS Hampshire maintains a database of all sample takers and their unique sample taker code which is required for the completion of the HMR101 form. It is the responsibility of the individual sample taker to ensure that their training is up to date and that the practice’s cervical screening clinical lead is aware of any training attended. Any sample taker who does not attend three yearly updates or provide evidence of this will be removed from the sample taker register.

 

Basic training

Sample takers should have attended an initial basic training course containing a theoretical and practical component. The theoretical component should cover:

·    the NHS Cervical Screening Programme

·    the background to cervical screening

·    organisation of the NHS Cervical Screening Programme, including local laboratory arrangements

·    equality of access to cervical screening

·    understanding the test results

·    anatomy and physiology of the pelvic organs

·    practical aspects of taking cervical samples

 

During the practical component, the trainee sample taker should:

·    observe at least two samples being taken

·    take a minimum of five samples under supervision

·    when it is agreed appropriate, take a minimum of 20 unsupervised samples

·    undergo a final clinical assessment when a minimum of 20 cytological adequate samples have been taken

 

Update training

The NHSCSP guidance states that sample takers should undertake a minimum of one half day’s training every three years. Update training should cover:

·    current developments in the cervical screening programme both nationally and locally

·    recent literature relevant to sample taking, sampling devices and women’s needs

·    changes to local screening policies and procedures

·    personal learning needs

·    the need to undertake appropriate personal audit

 

It is essential that the practice clinical lead attends appropriate update training every three years and wherever possible, all sample takers should attend this training. However, it recognised locally that occasionally a sample taker may not be able to attend the update training, in which case if the clinical lead is registered with NHS Hampshire as a clinical lead, they can provide cascade training, covering the five points above.

 

Wessex Local Medical Committees (LMCs) have agreed that cascade training can be delivered to sample takers by the practice clinical lead who has attended update training. The LMCs also state that if any clinician does not feel they are professionally competent to take cervical smears they should either stop taking smears or arrange retraining.

http://www.wessexlmcs.com/cervical_smear_tests_and_cervical_cytology.html

 

Liquid based cytology training

Since 2008, the LBC method has been used to prepare cervical samples for laboratory examination. This changeover required all sample takers to undergo training in the LBC technique for sample collection. Sample takers who have not been LBC-trained should receive cascade training from their cervical clinical lead (or other appropriately trained practitioner) using the cascade training checklist.

 

Contact information

For information about local training providers, contact the NHS Hampshire screening team on 02380 627633 or screeningadmin@hampshire.nhs.uk 

 

 

Last updated July 2010

 
 
 
Last updated at 19:32, 24 Jul 2011
 
 

Dorset GP Centre
Bournemouth University, Royal London House, Christchurch Road, Bournemouth, Dorset, BH1 3LT.
www.dorsetgpcentre.org. email: gpcentre@bournemouth.ac.uk. tel: + 44 (0) 1202 962165.

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