Junior doctor assessment form

Junior doctor assessment form

Apr 6, 2015 0
onthepods,Working & training in healthcare
Script Writer:  Duncan Campbell
Summary Writer:  Duncan Campbell
Editor:  James Edwards
Interviewee:  James Edwards

Dr James Edwards, who usually hosts the onthewards podcasts, talks about the new national intern assessment form and provides an overview on the importance of ongoing learning and development for junior doctors.

James is a Senior Staff Specialist in Emergency Medicine at Royal Prince Alfred Hospital, Chair of the NSW Prevocational Training Council and Chair of the Preinternship (PRINT) committee at the University of Sydney. He previously held the position of Director of Prevocational Education and Training at Royal Prince Alfred Hospital for 6 years.

He was awarded the Geoff Marel award in 2013 for outstanding contribution to the education and training of junior doctors in New South Wales.  This was followed by a nomination for the Australian Medical Educator of the year in 2013 at the National Prevocational Conference.  James has also completed a Masters of Medical Education at the University of Sydney.

At Royal Prince Alfred Hospital, he is the Chair of the Medical handover committee and was a member of the Local Health Districts Handover Committee.  James received a quality health award for his clinical lead in developing an electronic medical handover.  He was the clinical lead in the hospitals recent National Standards and Accreditation survey for Standard 6:  Clinical Handover.  James has a strong interest in patient safety with membership on the hospital Patient Care Committee and participation on local and district Root Cause Analysis investigation.

He has also spoken at local and national education conferences on the topics of assessment, clinical handover and junior doctor burnout.

Junior doctor assessment form

With Dr James Edwards, Chair of Prevocational Training Council, Health Education and Training Institute of NSW (HETI) and Dr Paul Hamor, Director of Prevocational Education and Training (DPET), Royal Prince Alfred Hospital, New South Wales, Australia

 

This year a new National Intern Assessment Form has been created to review and provide feedback to junior doctors. James and Paul discuss the new form and give an overview of the importance of ongoing learning and development for junior doctors.

  • To ensure patient safety
  • To provide feedback to junior doctors to help them improve
  • To ensure a minimum standard and level of competency that junior doctors must achieve before they are awarded general registration
  • At the beginning of your internship, you are granted provisional registration
  • To be awarded general registration, you must complete an internship comprising a minimum of 47 weeks of clinical professional experience including 10 weeks of surgery, 10 weeks of medicine, and 8 weeks of emergency care
  • Across the internship, you must attain a level that your supervisors deem appropriate, and that meets the criteria of the National Intern Outcome Statements
  • Based on the results of assessment conducted throughout the internship, your supervisors will contribute to a recommendation to the Medical Board of Australia for general registration
  • Historically general registration was sufficient to commence GP training
  • Today most junior doctors complete two prevocational years at a teaching hospital before registering with a vocational college
  • A National Internship Review is currently taking place
  • Each term, you will complete a mid-term and end-of-term assessment
  • Across the 5 terms, your supervisors will contribute to the recommendation to the MBA on the successful completion of internship
  • The MBA will look at performance over the whole year
  • Failing an individual term does not mean an intern will necessarily fail their internship
  • Interns should take on board feedback they receive to learn and improve the way they practise
  • The new form is designed to align with the Graduate Medical Outcome Statements of Australian medical schools, and incorporate the new National Intern Outcome Statements to create a continuum of learning and development from medical school to internship
  • The form should be used to assess interns against the National Intern Outcome Statements, and not just as a tick box exercise
  • The form contains 4 domains, each with a series of subsections that contain descriptors or behavioural anchors that are used to provide a rating from 1-5
  • All junior doctors should read the form at the beginning of the term and go through it with their supervisor during the orientation process
  • The junior doctor should discuss what goals they would like to achieve, as well as expectations that the supervisor has of the junior doctor during the term
  • The junior doctor should ask their supervisor how they will be assessed
  • Plans can be made for the mid-term and end-of-term assessment
  • Responsibility should be shared between the junior doctor and their supervisor
  • Certain domains are difficult to assess, and the junior doctor should provide relevant information to help their supervisor to rate them appropriately
  • Assessment should take the form of a discussion
  • Yes, the form is designed to target the responsibilities of the intern and what they need to be able to perform by the end of the internship
  • If you are rate well in each of the domains, we can be confident that you have the necessary skills and attitudes for general registration
  • As a junior doctor, the process of self assessment can be challenging
  • We would like junior doctors to reflect on their performance during the term and identify what they have done well and what areas they could improve on, so that they can continue to work on these areas
  • Self assessment allows the supervisor to see if the junior doctor has insight into areas in which they perform well and other areas where they feel they need to improve
  • If there is a discrepancy between the self assessment and supervisor assessment, this requires attention and further discussion
  • Self assessment is an important aspect of adult learning, and valuable skill will continue through the training process, and should be adopted to lifelong learning practice both at and outside of work
  • Feedback should be collected from all members of the team including consultants, fellows and registrars as well as nurses and allied health staff
  • Other information will be collected by reading progress notes, reviewing medication charts and discharge summaries, supervising practical tasks and contributions to multidisciplinary team meetings and journal clubs
  • A single assessment of borderline or unsatisfactory does not automatically mean that the junior doctor will fail the year
  • An unsatisfactory assessment can be redeemed by the junior doctor improving subsequent performance to meet the National Intern Outcome Statements
  • It should be regarded as a wake up call for the junior doctor, requiring self reflection
  • Sometimes the term itself is problematic, but there will always be areas that the junior doctor can improve
  • An Improving Performance Action Plan should be devised with the supervisor and DPET to create a plan for how to improve, and how and when this will be assessed
  • It is the responsibility of the supervisor and DPET to ensure that junior doctors who are under-performing do not slip through the cracks
  • The information from the form is typically kept within the hospital, and should not be released to anyone else
  • Completed forms will not be accessible to future employers, and should not be used for employment purposes
  • The only information that vocational colleges require is a statement from your DCT or DPET with a list of terms attempted and passed
  • Information from these assessment forms may be reviewed by the Intern Assessment Review group, and they will make the final decision about whether or not an intern is recommended for general registration
  • Yes, residents require ongoing assessment despite the fact that they have already been awarded general registration
  • In NSW, the same form is used and called a Junior Doctor Assessment Form
  • Although as an intern, you should have achieved all of the outcome statements, they are still applicable for residents and even registrars
  • Assessment is required to provide structured feedback to residents and help them to improve as junior doctors
  • Learning is a lifelong task that will continue well beyond the internship
  • Some vocational colleges require junior doctors to complete assessment forms for each term so that the DCT or DPET can definitively say that the junior doctor has passed all of their terms
  • Photocopy and file all of your end of term assessment forms so that you can provide them to your DCT or DPET when you need a statement saying that you have completed all of your terms before you apply to vocational colleges

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Tags: #JMO Assessment

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