ADVANCED MASTERY OF ADVANCED MASTERY OF THE e-PORTFOLIOTHE e-PORTFOLIO

HDR HDR

4.11.104.11.10

SET OBJECTIVESSET OBJECTIVES

WHY this topic?WHY this topic? WHAT DO YOU WANT TO GET OUT WHAT DO YOU WANT TO GET OUT

OF TODAY?OF TODAY?

ProgrammeProgramme ObjectivesObjectives Changes to the eportfolioChanges to the eportfolio Engaging with the eportfolioEngaging with the eportfolio What to do pre ES meetingWhat to do pre ES meeting Why do trainees go to panel-what Why do trainees go to panel-what

happens at a panel?happens at a panel? Naturally Occurring evidence.Naturally Occurring evidence. Log entries-How to make better Log entries-How to make better

reflection.reflection. Exercises on reflection and validationExercises on reflection and validation

UPDATE Eportfolio v5UPDATE Eportfolio v5 Need to signNeed to sign‘Probity: Professional Obligations’, ‘Probity: Professional Obligations’,

‘Health: Professional Obligations’ and ‘Health: Professional Obligations’ and ‘Educational Agreement’ need to be signed at ‘Educational Agreement’ need to be signed at the start of Training in a Deanery. If you the start of Training in a Deanery. If you change Deanery, you will need to resign these. change Deanery, you will need to resign these. You will not be able to enter Learning Log You will not be able to enter Learning Log entries without these three being signedentries without these three being signed

. Your Educational Supervisor will not be able . Your Educational Supervisor will not be able to start a review, without countersigning the to start a review, without countersigning the Educational Agreement. Educational Agreement.

Probity: Convictions and disciplinary actions, Probity: Convictions and disciplinary actions, and Health: Regulatory and voluntary and Health: Regulatory and voluntary proceedings now must be signed for each proceedings now must be signed for each review. There will be a review by review option review. There will be a review by review option for you to sign these. You cannot accept a for you to sign these. You cannot accept a review without signing them review without signing them

  

UPDATE Eportfolio v5UPDATE Eportfolio v5 ES must create a review before you can ES must create a review before you can

update your self assesssmentupdate your self assesssment Educational Supervisor's review - Educational Supervisor's review -

Educational Supervisors cannot sign & Educational Supervisors cannot sign & submit a review unless the Trainee has submit a review unless the Trainee has completed the Competences Self-Rating.completed the Competences Self-Rating.

    Expanded rating scales-relate to stage-Expanded rating scales-relate to stage- NFD – Below Expectations; NFD – Meets NFD – Below Expectations; NFD – Meets

Expectations; NFD – Above ExpectationsExpectations; NFD – Above Expectations Competent for LicensingCompetent for Licensing ExcellentExcellent

Reviews come in RDMP clustering Reviews come in RDMP clustering modelmodel

Relationship

Professionalism

Management

Diagnostics

Maintaining an Ethical Approach to Practice

Fitness to Practice

Maintaining Performance Learning and Teaching

Primary Care Admin and

IMT

Community Orientation

Managing Medical

Complexity

Clinical Management

Making a Diagnosis Making Decisions

Data Gathering & Interpretation

Practising Holistically

Communication & Consulting Skills

Working with Colleagues & in Teams

RDMp Clustering Model

E –portfolio Version 6.0E –portfolio Version 6.0– – Planned release date - early August 2011Planned release date - early August 2011It was agreed that major changes to the ePortfolio will only be It was agreed that major changes to the ePortfolio will only be

introduced at the start of a new ST year. Version 6.0 will be introduced at the start of a new ST year. Version 6.0 will be the next major update, and will be released in early August the next major update, and will be released in early August 2011.2011.

   The list of work for Version 6.0 is still very much a work in The list of work for Version 6.0 is still very much a work in

progress, but at the moment we are planning to address the progress, but at the moment we are planning to address the following:following:

   A major review of the curriculum and its likely impact on the A major review of the curriculum and its likely impact on the

ePortfolioePortfolio A review of the Learning Log functionality and linkageA review of the Learning Log functionality and linkage A review of the Case Based Discussion (CBD) WPBA toolA review of the Case Based Discussion (CBD) WPBA tool Minor aesthetic improvements e.g. text display and layout of Minor aesthetic improvements e.g. text display and layout of

tablestables Housekeeping of the database and updating coding for the Housekeeping of the database and updating coding for the

websitewebsite  

Engaging with the E-Engaging with the E-portfolioportfolio

Common Reasons Why Trainees don't make effective Common Reasons Why Trainees don't make effective use of their e-portfoliouse of their e-portfolio

• • do not understand its value (both in terms of do not understand its value (both in terms of assessment, i e for others, and in terms of recording assessment, i e for others, and in terms of recording experiences and reflection, i e for self experiences and reflection, i e for self

does understand its value but hasn’t got into a routine of does understand its value but hasn’t got into a routine of doing it, in which case may need rather explicit doing it, in which case may need rather explicit suggestion of a routine  suggestion of a routine  

does understand its value but thinks can’t find the time does understand its value but thinks can’t find the time in his busy job in his busy job

does understand its value but is lazy and/or disorganised does understand its value but is lazy and/or disorganised doesn’t know how to do it – in this case, he might need doesn’t know how to do it – in this case, he might need

to look at someone else’s.  You could get permission to look at someone else’s.  You could get permission from one of your other supervisees to show him/her from one of your other supervisees to show him/her theirs? Mainly the reflective aspects.theirs? Mainly the reflective aspects.

  confused by moving goalposts! confused by moving goalposts! 

Engaging with the E-Engaging with the E-portfolioportfolio

Make entries personalMake entries personal How many/often?- 2 -3 per week How many/often?- 2 -3 per week

avoid clusteringavoid clustering Quality not quantityQuality not quantity Have it open in surgery –so that can Have it open in surgery –so that can

do brief one liner notes at end on do brief one liner notes at end on relevant cases and develop laterrelevant cases and develop later

Trainee suggestions to engage in Trainee suggestions to engage in e-portfolioe-portfolio

What do I write? -familiarise with curriculum headings and What do I write? -familiarise with curriculum headings and competences and what they mean to use as framework to followcompetences and what they mean to use as framework to follow

Time issues-Time issues- consider coming in half an hour early each day during your hospital or consider coming in half an hour early each day during your hospital or

GP post to add log entriesGP post to add log entries load the e-portfolio at the same time as you do your GP surgery; in load the e-portfolio at the same time as you do your GP surgery; in

that way you can add 'rough notes' on interesting patients you see that way you can add 'rough notes' on interesting patients you see and you can then 'smarten' them up laterand you can then 'smarten' them up later

-use your half day admin time to add in entries-use your half day admin time to add in entries use 'gaps' in your daily hospital work as opportunities to add stuff onuse 'gaps' in your daily hospital work as opportunities to add stuff on - if it takes ages to drive home (because of rush hour traffic eg after - if it takes ages to drive home (because of rush hour traffic eg after

half day release), consider pulling over and adding some stuff on until half day release), consider pulling over and adding some stuff on until the traffic dies down. Of course, you may wish to invest in mobile the traffic dies down. Of course, you may wish to invest in mobile broadband to do this.broadband to do this.

Change your attitude: many of you hate the eportfolio and feel Change your attitude: many of you hate the eportfolio and feel sick at the thought of it. But the e-portfolio is here to stay. If one sick at the thought of it. But the e-portfolio is here to stay. If one cannot change the e-portfolio, then perhaps one needs to change cannot change the e-portfolio, then perhaps one needs to change oneself. Change your attitude and adapt to it. The more you start oneself. Change your attitude and adapt to it. The more you start looking at it positively, the less it will impact on you negatively. looking at it positively, the less it will impact on you negatively. LIKE LIFE! LIKE LIFE! 

Typing skills –consider typing tutor ('Mavis Beacon Teaches Typing skills –consider typing tutor ('Mavis Beacon Teaches Typing' - type this into somewhere like Amazon; costs less that Typing' - type this into somewhere like Amazon; costs less that £20.) or digital dictation software eg Dragon Naturally speaking. £20.) or digital dictation software eg Dragon Naturally speaking. 

Suggestions re quantitySuggestions re quantity

Non WBPA MINIMUM criteria to be achieved prior to the end Non WBPA MINIMUM criteria to be achieved prior to the end of the ST yearof the ST year  

ST1ST1 96 quality log entries (10 pages of the e-portfolio) and 12 SMART 96 quality log entries (10 pages of the e-portfolio) and 12 SMART

PDP entriesPDP entries Reflections on post held, 2 Presentations, 6 x SEAReflections on post held, 2 Presentations, 6 x SEA  ST2ST2 112 additional quality log entries (12 additional pages of the e-112 additional quality log entries (12 additional pages of the e-

portfolio and an additional 18 SMART PDP entries - portfolio and an additional 18 SMART PDP entries - Running Running total = 22 pages of e-portfolio entries and 24 SMART PDP total = 22 pages of e-portfolio entries and 24 SMART PDP entries. Reflections on post held, 4 Presentations, 12 x SEAentries. Reflections on post held, 4 Presentations, 12 x SEA

  ST3ST3 144 additional quality log entries (15 additional pages of the e-144 additional quality log entries (15 additional pages of the e-

portfolio) and an additional 18 SMART PDP entries - portfolio) and an additional 18 SMART PDP entries - Running Running total = 37 pages of e-portfolio entries and 36 SMART PDP total = 37 pages of e-portfolio entries and 36 SMART PDP entries. Reflections on post held, 6 Presentations, 18 x SEA, entries. Reflections on post held, 6 Presentations, 18 x SEA, 1 x two cycle audit1 x two cycle audit

    

PDP LinkingPDP Linking Try and write PDPs in terms of either what Try and write PDPs in terms of either what

knowledge, skills or attitudes you need to knowledge, skills or attitudes you need to develop.develop.

Remember, you can "send" outstanding Remember, you can "send" outstanding things from your learning log entries to your things from your learning log entries to your PDP - use it because it saves you writing it PDP - use it because it saves you writing it all out again for your PDP.all out again for your PDP.

If you don't have time to write out the PDP If you don't have time to write out the PDP completely, why not just add something completely, why not just add something 'quick and dirty' for the time being to serve 'quick and dirty' for the time being to serve as a signpost for you to smarten up later?as a signpost for you to smarten up later?

Whilst you dont have to be too Whilst you dont have to be too comprehensive, you do have to be specific.comprehensive, you do have to be specific.

SMART PDPSMART PDP

The SMART model was developed by The SMART model was developed by psychologists as a tool to help people set psychologists as a tool to help people set and reach their goals. It’s a simple and reach their goals. It’s a simple approach that lends itself to creating good approach that lends itself to creating good PDP entries in your e-portfolio.PDP entries in your e-portfolio.

SSpecific pecific MMeasurable easurable AAttainable ttainable RRelevant elevant TTime-boundime-bound

SMARTSMART Specific Specific

Is your goal well-defined? Avoid setting unclear Is your goal well-defined? Avoid setting unclear or vague objectives; instead be as precise as or vague objectives; instead be as precise as possible. possible.

Instead of: To be a better GPInstead of: To be a better GPMake it specific: To develop my consultation Make it specific: To develop my consultation skills, especially those relating to skills, especially those relating to communication. communication.

MeasurableMeasurable Be clear how will you know when you have Be clear how will you know when you have achieved your goal. Using numbers, dates and achieved your goal. Using numbers, dates and times is one way to represent clear objectives. times is one way to represent clear objectives.

Instead of: Feel better about my consultationsInstead of: Feel better about my consultationsMake it measurable: Better PSQ outcomes and Make it measurable: Better PSQ outcomes and achieving more COT competencies during achieving more COT competencies during assessment.assessment.

SMARTSMARTAttainable Attainable Setting yourself impossible goals will only end in Setting yourself impossible goals will only end in

disappointment. Make your goals challenging, but disappointment. Make your goals challenging, but realistic. realistic.

Instead of: Master consultation skills by the end of the Instead of: Master consultation skills by the end of the monthmonthMake it attainable: I will go on a consultation skills Make it attainable: I will go on a consultation skills course and read ‘The naked consultation’. course and read ‘The naked consultation’.

Relevant Relevant Try and step back and get an overview of all the different Try and step back and get an overview of all the different

areas of your life: Academic, Personal and Career. areas of your life: Academic, Personal and Career. Consider how relevant each objective is to the overall Consider how relevant each objective is to the overall picture. picture.

Time-bound Time-bound Set a time scale for completion of each goal. Even if you Set a time scale for completion of each goal. Even if you

have to review this as you progress, it will help to keep have to review this as you progress, it will help to keep you motivated. you motivated.

Instead of: I will address these issues.Instead of: I will address these issues.Make it time-bound: By the end of the my current post I Make it time-bound: By the end of the my current post I will have been on the course and read the book. will have been on the course and read the book.

STRs-PRE ES meetingSTRs-PRE ES meeting Arrange meeting! Ask ES to create a Arrange meeting! Ask ES to create a

review.review. log and share an e-portfolio entry entitled log and share an e-portfolio entry entitled

Ed Sup Rev current date. Attach:Ed Sup Rev current date. Attach: COT & CBD competency mapping COT & CBD competency mapping HDR spreadsheet and sick leave/all leave HDR spreadsheet and sick leave/all leave

spreadsheet. spreadsheet. List complaints.List complaints. Ensure CSR report done.Ensure CSR report done. Ensure self rating assessment and PDP up Ensure self rating assessment and PDP up

to date.to date. Ensure compulsory assessments (inc MSF Ensure compulsory assessments (inc MSF

in modular posts)?include NOEin modular posts)?include NOE Ensure last objectives achieved.Ensure last objectives achieved. Ensure declarations all signed offEnsure declarations all signed off

Deanery Guidelines ESDeanery Guidelines ES

How Many ES Meetings and When?How Many ES Meetings and When?   ST1: 2 meetings in first post, 1 meeting in second  ST1: 2 meetings in first post, 1 meeting in second 

(i.e. 3 for that year: 1 informal + 2 formal) (i.e. 3 for that year: 1 informal + 2 formal) ST2: 1 per 6m post (ie 2 for that year: both formal) ST2: 1 per 6m post (ie 2 for that year: both formal) ST3: 1 per 6m post (ie 2 for that year: both formal)ST3: 1 per 6m post (ie 2 for that year: both formal)   So, especially during the period Feb-Aug of every So, especially during the period Feb-Aug of every

year (as that is when most trainees will move onto year (as that is when most trainees will move onto the next ST stage) make sure you have had your the next ST stage) make sure you have had your second ES meeting before the end of Maysecond ES meeting before the end of May

WHY do STs get referrred WHY do STs get referrred to central Deanery panelto central Deanery panel

Majority incomplete evidence egMajority incomplete evidence eg out of hours sessions, out of hours sessions, patient satisfaction questionnaires and patient satisfaction questionnaires and other workplace based assessment other workplace based assessment

tools. tools. NOE(Naturally Occurring Evidence)NOE(Naturally Occurring Evidence) Confusion modular posts /LTFTTConfusion modular posts /LTFTT Clustering minimal evidence.Clustering minimal evidence.

ARCP PANEL ARCP PANEL OUTCOMESOUTCOMES

SATISFACTORY –FOR PROGRESSION OR SATISFACTORY –FOR PROGRESSION OR CCTCCT

OUT OF PROGRAMMEOUT OF PROGRAMME MAINLY SATISFACTORY-ARCP NOT MAINLY SATISFACTORY-ARCP NOT

COMPLETED;FEEDBACK TO TRAINEE TO COMPLETED;FEEDBACK TO TRAINEE TO OBTAIN MISSING EVIDENCE-PANEL OBTAIN MISSING EVIDENCE-PANEL CHAIR REVIEWS EVIDENCE 2W LATER.CHAIR REVIEWS EVIDENCE 2W LATER.

POSSIBLE OR LIKELY UNSATISFACTORY-POSSIBLE OR LIKELY UNSATISFACTORY-ARCP NOT COMPLETED ;WRITTEN ARCP NOT COMPLETED ;WRITTEN EVIDENCE TO DEANERY RE REASONSEVIDENCE TO DEANERY RE REASONS

ONLY ONE OUTCOME PER TRAINEE IN ONLY ONE OUTCOME PER TRAINEE IN EACH ARCP CYCLE EACH ARCP CYCLE

OOHOOH TThere is the service commitment to out of hours here is the service commitment to out of hours

work that is specified for each training post. Not work that is specified for each training post. Not attending OOH sessions is a probity issue. attending OOH sessions is a probity issue.

In an Innovative Training Post (ITP) most ITPs will In an Innovative Training Post (ITP) most ITPs will have the same monthly (6 hour) session of OOH work have the same monthly (6 hour) session of OOH work as normal GP training posts. Some will have on call as normal GP training posts. Some will have on call commitments to the modular component of their post commitments to the modular component of their post – eg on labour ward or hospice. make clear in the – eg on labour ward or hospice. make clear in the portfolio. If no OOH sessions logged panels will find portfolio. If no OOH sessions logged panels will find the portfolio unsatisfactory. (PSQ also due in modular the portfolio unsatisfactory. (PSQ also due in modular posts)posts)

Documentation of learning in OOH sessions -linking Documentation of learning in OOH sessions -linking that to chapter 7 of the GP curriculum – Care of the that to chapter 7 of the GP curriculum – Care of the Acutely Ill. Acutely Ill.

One trainee documented 2 OOH sessions in two One trainee documented 2 OOH sessions in two months prior to panel. A total of only 3 patients had months prior to panel. A total of only 3 patients had been seen in these two sessions. This was considered been seen in these two sessions. This was considered to be unsatisfactory. to be unsatisfactory.

Clustering/demandClustering/demand

OOH contOOH cont

Advise to document for each OOHAdvise to document for each OOH The type of session – telephone triage, The type of session – telephone triage,

visiting doctor, base doctorvisiting doctor, base doctor The number of patients seen.The number of patients seen. A selection of the most interesting A selection of the most interesting

patientspatients The significant learning points and,The significant learning points and, Link these to the curriculum(esp care Link these to the curriculum(esp care

acurtely ill)acurtely ill)

Naturally Occurring Naturally Occurring EvidenceEvidence

1) Significant Event Analysis – 3 per 1) Significant Event Analysis – 3 per 6 month post – file under Significant 6 month post – file under Significant Event AnalysisEvent Analysis

2) Reflection on key learning points 2) Reflection on key learning points from each post – file in Reading – from each post – file in Reading – expected length 1 side A4expected length 1 side A4

3) Audit or QoF review or NPMS 3) Audit or QoF review or NPMS Project – x1 in 3 year training – file Project – x1 in 3 year training – file in Audit/ Projectin Audit/ Project

NOE (cont)NOE (cont) 4) Case study – 2 per year – file in 4) Case study – 2 per year – file in

AuditAudit 5) Statement of Total Leave Taken – 5) Statement of Total Leave Taken –

file in courses/certificatesfile in courses/certificates 6)Attendance Record at VTS teaching 6)Attendance Record at VTS teaching

– supplied by VTS administrator– supplied by VTS administrator 7) Complaints and adverse incident 7) Complaints and adverse incident

reports – if any. File in Professional reports – if any. File in Professional ConversationsConversations

Learning LogLearning Log

Role of the Learning LogRole of the Learning Log Your learning log is your personal learning record. Your learning log is your personal learning record.

Log entries that you choose to ‘share’ can be read Log entries that you choose to ‘share’ can be read and commented on by your clinical or educational and commented on by your clinical or educational supervisor. These entries will contribute to the supervisor. These entries will contribute to the evidence that your educational supervisor will evidence that your educational supervisor will consider at your 6 monthly educational supervision consider at your 6 monthly educational supervision meetings.  meetings. 

Maintaining your log is therefore just as important as Maintaining your log is therefore just as important as completing your formal assessments.completing your formal assessments.

Log entries can contribute to your evidence in two Log entries can contribute to your evidence in two ways.  They determine your curriculum coverage and ways.  They determine your curriculum coverage and contribute to the evidence in the 12 competency contribute to the evidence in the 12 competency areas if they are ‘validated’.areas if they are ‘validated’.

Learning LogLearning Log

When linking to curriculum headings take care to look at When linking to curriculum headings take care to look at the learning objectives in the relevant curriculum the learning objectives in the relevant curriculum statement and ask yourself: statement and ask yourself:

- does my log entry provide evidence that relates to the - does my log entry provide evidence that relates to the specific learning objectives in this statement?specific learning objectives in this statement?

Although in many cases an individual entry may merit Although in many cases an individual entry may merit more than one curriculum heading, try to ensure that you more than one curriculum heading, try to ensure that you don’t choose inappropriate ones.don’t choose inappropriate ones.

Greater reflection and ability to validate against Greater reflection and ability to validate against competences is likely with clinical encouters;SEA rather competences is likely with clinical encouters;SEA rather than lectures or tutorials( which can still be useful for than lectures or tutorials( which can still be useful for curriculum coverage)curriculum coverage)

Log entriesLog entries

Log entries should on average show:Log entries should on average show: evidence of critical thinking & analysis, evidence of critical thinking & analysis,

describing own thought processesdescribing own thought processes self awareness demonstrating openness self awareness demonstrating openness

and honesty about performance and some and honesty about performance and some consideration of feelings generatedconsideration of feelings generated

evidence of learning, appropriately evidence of learning, appropriately describing what needs to be learned, why describing what needs to be learned, why & how& how

appropriate linkage to curriculumappropriate linkage to curriculum demonstration of demonstration of behaviour behaviour that allows that allows

linkage to one or more competency areaslinkage to one or more competency areas

Gibbs Reflective CycleGibbs Reflective Cycle

Reflection templateReflection template

Reflective Writing: role and Reflective Writing: role and functionsfunctions

• • To maximise the effectiveness of experientialTo maximise the effectiveness of experiential

learninglearning

• • To evaluate one’s practiceTo evaluate one’s practice

• • To promote critical thinkingTo promote critical thinking

• • To facilitate the integration of theory with To facilitate the integration of theory with practicepractice

• • To generate theoryTo generate theory

• • To evaluate a learning activityTo evaluate a learning activity

• • To demonstrate that learning has taken To demonstrate that learning has taken placeplace

Reflective writing: Reflective writing: descriptiondescription

• • What were the significant background What were the significant background factors to this experience?factors to this experience?

• • Describe the experienceDescribe the experience

– – Sequence of eventsSequence of events

– – ActionsActions

– – ObservationsObservations

• • What essential factors contributed to What essential factors contributed to the experience?the experience?

Reflective Writing: Reflective Writing: analysisanalysis

• • What were the consequences of my What were the consequences of my actions?actions?

• • How do I feel about the experience?How do I feel about the experience?

• • What factors influenced my decision What factors influenced my decision and actions?and actions?

• • What knowledge influenced my What knowledge influenced my decision and actions?decision and actions?

Reflective Writing: Reflective Writing: evaluationevaluation

What went well; what went badly?What went well; what went badly? Could I have dealt better with the Could I have dealt better with the

situation?situation? What other choices did I have?What other choices did I have? What would have been the What would have been the

consequences ofconsequences of

acting on these other choices?acting on these other choices?

Reflective Writing: action Reflective Writing: action planplan

How should I change my practice?How should I change my practice?

BehaviourBehaviour

Standards, proceduresStandards, procedures

• • Should I suggest changes in policy?Should I suggest changes in policy?

• • What constraints may exist?What constraints may exist?

Review changes and their effects!Review changes and their effects!

Reflective Writing: new Reflective Writing: new perspectivesperspectives

• • What have I learnt from this What have I learnt from this experience?experience?

• • How has this experience affected my How has this experience affected my thinking?thinking?

ValidationValidationWhy does validating entries matter?Why does validating entries matter? The learning log helps to balance the educational The learning log helps to balance the educational

portfolio and provides additional evidence of portfolio and provides additional evidence of learning and progression, capturing evidence learning and progression, capturing evidence from learning opportunities in the workplace.from learning opportunities in the workplace.

There is no limit to the number or quality of There is no limit to the number or quality of entries that trainees can make in their eportfolios,entries that trainees can make in their eportfolios,but not all of them can or should be validated. For example, but not all of them can or should be validated. For example,

attendance atattendance atVTS seminars. Entries which cannot be validated may still VTS seminars. Entries which cannot be validated may still

be useful for curriculum coverage.be useful for curriculum coverage. Once validated, each entry Once validated, each entry then forms part of the then forms part of the

trainee’s evidence of progression.trainee’s evidence of progression. Entries are validated against the 12 areas of the Entries are validated against the 12 areas of the

competency framework. competency framework.

ValidationValidation

What does validating an entry mean?What does validating an entry mean?the entry fulfils the following two requirements:the entry fulfils the following two requirements: a) a) It addresses one or more of the 12 It addresses one or more of the 12

competence areascompetence areas b) b) It demonstrates meaningful reflectionIt demonstrates meaningful reflection By validating a log entry you are confirming that By validating a log entry you are confirming that

this is valid evidence of learning in an this is valid evidence of learning in an appropriate competency area. You are appropriate competency area. You are not not making a judgement about whether that making a judgement about whether that competence has been achieved.competence has been achieved.

Who Reads entries and validates-ES or CS?Who Reads entries and validates-ES or CS?

                                                                                   

Competence Area MSF PSQ COT CbD CEX CSR

Communication and consultation skills xx xx xx

 

xx xxPractising holistically  

xx xx xx 

xxData gathering and interpretation

xx 

xx xx xx xxMaking a diagnosis/decisions

xx 

xx xx xx xxClinical management

xx 

xx xx xx xxManaging medical complexity      

xx xx xxPrimary care admin and IMT      

xx   x

Working with colleagues and in teams xx

   

xx 

xxCommunity orientation      

xx 

xxMaintaining performance,

learning and teaching xx     

xx xxMaintaining an ethical approach

xx   

xx 

xxFitness to practise  x    

xx 

xx

Example of a good log Example of a good log entryentry

Current SelectionsCurrent Selections Professional competences 4 Professional competences 4

Making a diagnosisMaking a diagnosis Professional competences 5 Professional competences 5

Clinical managementClinical management Curriculum statement headings 8 Curriculum statement headings 8

Care of children and young peopleCare of children and young people Curriculum statement headings Curriculum statement headings

15 15 Cardiovascular problemsCardiovascular problems

What Happened?What Happened?

A 2 week old baby was brought to the surgery A 2 week old baby was brought to the surgery with a history of a few days of coryzal with a history of a few days of coryzal symptoms and poor feeding. The parents symptoms and poor feeding. The parents thought that the baby had a viral infection. I thought that the baby had a viral infection. I examined the baby and thought that she had examined the baby and thought that she had some crepitations on the left lung. She was some crepitations on the left lung. She was also tachypnoeic and tachycardic. I was also tachypnoeic and tachycardic. I was concerned about this baby as she was not concerned about this baby as she was not feeding well and the parents mentioned that feeding well and the parents mentioned that she had been more sleepy than usual. I she had been more sleepy than usual. I discussed the case with the paeds registrar on discussed the case with the paeds registrar on call, who said it sounded like bronchiolitis and call, who said it sounded like bronchiolitis and suggested conservative management. However suggested conservative management. However I stressed that I felt this baby needed to be I stressed that I felt this baby needed to be assessed as she was not well and eventually assessed as she was not well and eventually the paeds registrar agreed to see the child. the paeds registrar agreed to see the child. 

What happened What happened subsequentlysubsequently

While in the children’s emergency While in the children’s emergency department, the baby had a department, the baby had a cardiorespiratory arrest, was cardiorespiratory arrest, was resuscitated and transferred to a resuscitated and transferred to a hospital in London. She had hospital in London. She had coarctation of the aorta and left basal coarctation of the aorta and left basal consolidation of the left lung. She was consolidation of the left lung. She was subsequently operated on and is now subsequently operated on and is now progressing well in intensive care.progressing well in intensive care.

What did you learn?What did you learn?

To be aware that accurate assessment of To be aware that accurate assessment of a baby is vital as they can be seriously a baby is vital as they can be seriously unwell and only display non-specific unwell and only display non-specific symptoms. I am very glad that I insisted symptoms. I am very glad that I insisted on sending the baby to hospital despite on sending the baby to hospital despite the objections of the paediatric the objections of the paediatric registrar. It felt very awkward at the registrar. It felt very awkward at the time, but it has taught me to trust my time, but it has taught me to trust my judgement and I will find it easier to be judgement and I will find it easier to be more assertive next timemore assertive next time

What will you do differently What will you do differently in the future?in the future?

On reflection, the baby arrested while On reflection, the baby arrested while she was in the CED. The parents took she was in the CED. The parents took her there by car. I could have arranged her there by car. I could have arranged a blue light ambulance to take her to a blue light ambulance to take her to hospital. However, although I thought hospital. However, although I thought she was unwell, I did not expect such a she was unwell, I did not expect such a serious underlying problem and she serious underlying problem and she was certainly not looking like a baby was certainly not looking like a baby that was about to arrest.that was about to arrest.

An example of a good An example of a good reflective log entryreflective log entry

What further learning needs What further learning needs did you identify?did you identify?

How & when will you address How & when will you address these?these?

Record createdRecord created

CommentsComments

Need to refresh my memory Need to refresh my memory re: congenital heart disease re: congenital heart disease & its presentation in & its presentation in neonates.neonates.

GP notebook & paediatric GP notebook & paediatric textbook, in the next couple textbook, in the next couple of weeks.of weeks.

15/12/2009 21:24:3215/12/2009 21:24:32

[16/12/2009 18:50:36]  [16/12/2009 18:50:36]  (Educational Supervisor)  You (Educational Supervisor)  You did extremely well here, did extremely well here, recognising the baby was not recognising the baby was not well and sticking by your own well and sticking by your own clinical judgment when a clinical judgment when a more specialist doctor was more specialist doctor was suggesting an alternative. suggesting an alternative. This can be a difficult thing to This can be a difficult thing to do and in this case saved this do and in this case saved this baby’s life. Well done.baby’s life. Well done.

Example of a good log Example of a good log entryentry

Current SelectionsCurrent Selections Professional competences 4 Professional competences 4

Making a diagnosisMaking a diagnosis Professional competences 5 Professional competences 5

Clinical managementClinical management Curriculum statement headings 8 Curriculum statement headings 8

Care of children and young peopleCare of children and young people Curriculum statement headings Curriculum statement headings

15 15 Cardiovascular problemsCardiovascular problems

An example of a good An example of a good reflective log entryreflective log entry

How does this compare with your How does this compare with your entries.entries.

Are the curriculum statements valid?Are the curriculum statements valid? What can you learn form this?What can you learn form this?

E portfolioE portfolio

Look at own entries in groups of 3.Look at own entries in groups of 3. How does your reflection compare How does your reflection compare

against the criteria?against the criteria? Do you think these are correctly Do you think these are correctly

linked?linked? Could these be validated against Could these be validated against

competences?competences? How could you improve your entries? How could you improve your entries?

Provide examples.Provide examples.

Reflection and validation Reflection and validation exercisesexercises

Eportfolio j smith2 Eportfolio j smith2 Password jsmith2Password jsmith2 Dr Pauline exampleDr Pauline example Can use dummy system Can use dummy system The username is trainer1The username is trainer1

The password is rcgpThe password is rcgp

PLENARYPLENARY

ANY LEARNING TO SHAREANY LEARNING TO SHARE FEEDBACK FORMSFEEDBACK FORMS FUTURE LEARNING NEEDSFUTURE LEARNING NEEDS