Educational Supervision
for those given an Extension to GP training
Who is this section for?
The information provided below is for those trainees who have been granted an extension to their GP training. GP Trainees who have been granted an extension read this section VERY carefully because it is highly unlikely they will be granted another extension if these requirements are not met. The section defines what you need to do in respect of your ePortfolio and WPBA during your extension. In summary – you still have to maintain them. So, if you’ve been granted an extension simply to give you another chance of doing an examination (like AKT or CSA), the bottom line is that you still need to continue working on your ePortfolio, doing WPBA and engaging in OOH. If you succeed in getting your AKT or CSA during your extension but fail to maintain your ePortfolio (especially the WPBA bit), you will still be at risk of not being given your CCT. So, please read this web page very carefully. Understand what is expected of you. This webpage is designed to make your training life easier.
Ramesh Mehay
First of all - work out your dates
- Date of the last working day: how many months have you been granted an extension? Ask for your your last working day – contact your GP School/GP Training Scheme administrator.
- Date of your ARCP panel: Also ask your GP Training Scheme Administrator or your GP School for the date of your ARCP. It will roughly be 2 weeks before the end working date. Check that they will ‘notify the RCGP Certification Unit that the CCT needs a fast turnaround action’. This will help you get your CCT on time for you to be able to apply for jobs in a timely way once you are qualified.
- Date of your ES meeting: Now that you have a central ARCP panel date, you will need to arrange an Educational Supervision Meeting about a week before that date.
- Contact your Educational Supervisor early to sort that out. Please send them a link to this webpage.
- In preparation for your ES meeting, you will still need to re-do your self-assessment of the 13 Professional Capabilities. Again, if there are competencies that were marked in the last ESR as ‘Competent for Licensing’, you can refer back to the evidence you used there. However, for those highlighted as anything less than this – you must provide more fuller evidence and incorporate any additional newer evidence acquired during the extension.
- Date for your CSR: Now that you have a date for the ES meeting, don’t forget that you will need to get a CSR done a week or two before that. So, work out that date too with your Clinical Supervisor and plug it into your diary.
- In fact, plug all of these dates into your diary and email a summary of them to both your Clinical and Educational Supervisors.
What does the trainee need to do before their ARCP panel?
There are TWO things that the trainee needs to show in their ePortfolio.
- Evidence for the competencies which the ARCP panel felt you were deficient on.
- Evidence to show continued learning
1. Evidence for the deficient capabilties
From your ARCP panel report and the ESR….
- List the Professional Competences which were highlighted for further work or development
- List anything else they felt was missing, needs extra work or what they expect to see at the next panel.
- Try and understand why they feel you need to do this extra work (you may need to enlist the help of your Trainer, Educational Supervisor and/or Training Programme Director). Make sure you have a good understanding about this.
- Now make a list of exactly what you need to do in terms of your ePortfolio, WPBA and OOH – make a list of specific evidence you need to provide to prove your competence. Make sure this list includes any evidence which the panel have specified. Also include WPBA elements (eg. CBD, COTs, MSF, new CSR) which provide good evidence for the missing/highlighted areas of concern. The type of evidence which provides a good basis for each competency can be found on this web page: www.bradfordvts.co.uk/edsupervision/evidence-for-rating-scales
- And finally, write an end of extension reflection focused around what has been learned in respect of the deficient areas of competence.
2. Evidence to show continued learning
A trainee in an extension still needs to do what any ordinary GP trainee would be expected to do in that period. This is IN ADDITION to the things specifically required by the ARCP panel. So, as a ROUGH guide…
- Continue to do COTs/CEXs – (full-time: 1 per month; part-time: 1 per two months).
Round off any decimals to the integer above (for example, 1.5 COTs for a part-time 3 month extension becomes 2 COTs). - Continue to do CBDs – (full-time: 1 per month; part-time: 1 per two months)
- Write some PDPs – (full-time: 2 per 3 month period; part-time: 1 per 3 month period)
- Continue to write log entries – (full-time: approx 6 per month; part-time: approx 3 per month) – remember to balance the clinical and non-clinical.
- Still engage in OOH – (full-time: 1 per month; part-time: 1 per two months)
Depends really if any of the 6 OOH competences are still deficient in terms of evidence. - If you need to do an MSF and/or a PSQ – PLEASE DO NOT LEAVE THESE TIL THE LAST MINUTE!!!
Do these in a timely way so that you and your Educational Supervisor can use the evidence from them to write the ESR and provide evidence to the panel. If you don’t keep an eye on these and find that towards the panel date you are still waiting for people to reply, you will find the panel unforgiving and you will not be granted any additional chances to ‘prove yourself’. - Before your panel and ES meeting
- upload an updated ES Workbook that covers the whole of the last ST year (including the extension). You will need to add new evidence to the existing one. The ES workbook is available from the downloads section above.
- upload a new Form R – detail any new complaints.
- Perhaps a FINAL learning log entry pulling all of your evidence together (especially around the any competencies that were deemed deficient).
Fitness to Practise
An ARCP panel have given John (the trainee) a 3 month extension on a full-time basis because he has failed one area of his Work Place Based Assessment – namely, the competency ‘Fitness to Practise’. They have written that they felt that he needed further development in this competency because…
Attitudinally….
- He did not respond appropriately to a recent complaint in a timely way. His attitude towards the complaint showed a lack of regard for the patient and did not consider their perspective.
- He has documented a number of times in his ePortfolio the pressures between personal and professional life but fails to detail how he plans to make this better.
- The ARCP panel felt that he has not reflected on his own ability to work as a safe doctor – he was recently very ill looking and came in to do a surgery (despite how commendable others have viewed this).
- Some of his colleagues have concerns as detailed in a recent MSF
Organisationally…
- Not engaging with the eP in a timely way despite repeated reminders.
- Delay in replying to the complaint despite being told to do so.
- Not organising OOH in a timely way – all rather last minute.
- Needing repeated reminders about things
- He seems to be getting behind with administrative tasks because of these struggles (as noted by the Clinical Supervisor – outstanding blood results and referrals).
So, what evidence will John need to provide for this competency?
- Provide a min of 3 CBDs (1 per month), with a big focus on item 10 – fitness to practise
- Provide 1-2 SEAs – where he demonstrates a positive attitude towards SEAs (rather than defensiveness)
- CSR – the Clinical Supervisor will need to write a detailed write up for items under Professionalism – in particular ‘shows respect for others’ and ‘deals appropriately with stress’ and ‘is organised, efficient and takes responsibility’ and under Management – in particular ‘keeps up to date and a commitment to learning’
- A new MSF – two reasons – because ARCP panel thought last one wasn’t good and also because other team members need to verify his Fitness to Practise – i.e. good time keeping, does letters, results, and other paper work on time, and is respectful of colleagues.
- A new end of post reflection – to demonstrate what John has LEARNED in the 3 month extension (rather than being defensive and providing all sorts of reasons as he did in the last one). Providing some specific comments on learning with respect to ‘Fitness to Practise’ (John should read the RCGP’s competency descriptor and use it to structure his reflection).
- He must continue to engage with the other elements of WPBA as is required of a trainee not in extension (i.e. 3 x COTs, 3 x CBDs etc is about the right numbers for a 3 month extension).
What does the Educational Supervisor need to do?
If the extension ES meeting is within 3 months of the last ESR,
- You can adopt what we call a ‘light touch approach’.What this means is that in the extension ES meeting you only need to concentrate on the areas that were marked as deficient in the ePortfolio, WPBA and the 13 Professional Competencies.
- Prioritise the evidence and your analysis on the areas which have been assessed as being below the expected standard but having required new WPBA evidence to be done.
- Be sure to make reference to the more recent CSR, COTs, CBDs, MSF, PSQ or other recent WPBA especially if these have been borderline in the past.
- For other areas of no concern – you can ‘refer to previous ESR’.
If the ES meeting is more than 3 months of the last ESR,
- A new detailed ESR needs to be done covering all competencies.
- Again, you can quote previous evidence for those areas which were deemed satisfactory.
- But remember to pay extra attention to those which were borderline or less than satisfactory and make use of the NEW evidence.
- Note: New COTs and CBDs should be marked competent overall if the trainee is ST3 and their next stage is for CCT. Otherwise, the panel mgiht have concerns that there was not continuing evidence of competence.
