Workplace Based Assessment

Formative workplace based assessments (WBAs) are designed to allow the registrar to gauge aspects of their performance in daily practice, and make improvements to specific areas, where necessary.

WBA in the training program include:

 Mini Clinical Evaluation Exercise (Mini-CEX)

 Direct Observation of Procedural Skills (DOPS)

 Case based Discussion (CbD)

WBA is registrar driven. Supervisors and registrars should note that:

1. Registrars must instigate each assessment by approaching an assessor (Clinical Training Supervisor (CTS) or any ACSP Fellow) and organising an appropriate time for the assessment to be conducted.

2. The registrar is responsible for providing the relevant form to the assessor prior to the agreed time for the assessment.

3. The assessor must rate the registrar and make notes on the assessment form during and/or immediately after the assessment encounter.

4. WBAs are an assessment for learning and as such, help to identify areas that the registrar needs to focus on. The assessor must consider the registrar’s year of training and take this into account when rating the registrar. The complexity of the case is noted at the top of the form so that the State Training Coordinator (STC) can interpret the ratings more accurately. 5. To be regarded as a satisfactory assessment, registrars must achieve a rating of satisfactory or higher for each item observed. Registrars are encouraged to use the WBA process as an opportunity to develop knowledge and skills as a Sport and Exercise Medicine Physician. As a result, a

registrar’s learning portfolio may contain multiple assessment forms on a similar topic area, which monitor improvement over time and culminate in a satisfactory assessment.

6. Registrars must complete a minimum of three WBA (Mini-CEX, DOPS or CbD) during each six-month period and request a variety of assessors to complete their assessments. Multiple assessments conducted by the same assessor in the same week will not be accepted toward completion of training program requirements.

7. The most important aspect of the assessment is the feedback process. Feedback is a two way process and the registrar should be asked what they thought was satisfactory and what they thought could be improved on, followed by constructive feedback from the assessor. The assessor should note a few specific strengths and areas of improvement on the assessment form. This is to guide the registrar on aspects of the encounter that could benefit from further learning and/or practice.

8. The assessment form must be signed by the assessor and the registrar. 9. The form is included in the registrar’s learning portfolio and will be

reviewed by the STC at the next six monthly progress meeting. The curriculum stipulates the type and minimum number of satisfactory

assessments registrars must complete during the training program. Registrars are encouraged to complete additional assessments in order to obtain feedback that will guide their development. Registrars who are unsuccessful in the Part 2 examination are encouraged to continue to complete Mini-CEX and CbD assessments.

WBA Ratings

The use of numerical grading and scale ratings can lead to a tendency for assessors to rate mid-scale. It is important that the rating is an accurate reflection of the registrar’s consulting or procedural skills during the assessment encounter (Mini- CEX and DOPS) or ability to manage a case that is the subject of the assessment (CbD). The following ratings are given for each item on each assessment form: 1. Unsatisfactory: Gaps in knowledge or skills that you would not expect of a registrar in this year of training.

2. Satisfactory: What you would expect for a registrar at this level, at this point during their training year.

3. Above Expected: Performing well, above expectation for current year of training, no concerns.

5.1 Mini Clinical Evaluation Exercise (Mini-CEX)

The Mini-CEX is a tool used to evaluate a range of core competencies that a registrar uses during day to day clinical work with patients. The Mini-CEX concentrates on the observation of a registrar taking a focused history and

performing a physical examination on a variety of common patient presentations. Registrars must complete a total of 12 satisfactory Mini-CEX assessments.

Registrars must complete eight satisfactory injury assessments on at least six of the following:  Wrist  Elbow  Shoulder  Lumbar Spine  Hip/Groin  Knee  Ankle  Foot

A mix of acute and overuse injuries is required.

Registrars must satisfactorily complete four different medical assessments. They may choose from:

 Exercise induced bronchospasm/asthma

 Epilepsy

 Risk factors for Chronic Disease e.g. obesity, cardiovascular disease, metabolic syndrome/insulin resistance

 Type 1 or 2 Diabetes

 Tired athlete

 Chronic sore throat

 Osteoporosis

 Osteoarthritis of a major joint

An assessment on an alternate condition, suggested by the CTS, is also acceptable. Registrars are responsible for ensuring that over the four years of training they undertake Mini-CEX assessments on a variety of patients (e.g. different sex, age and athletic standard). Inclusion of an assessment on an athlete with a disability is desirable if feasible.

Mini-CEX assessments should take place in the normal working environment with NEW patients. It may be helpful for the practice staff to ask the patient what they are consulting the doctor about at the time of the patient booking. The registrar can then plan to complete a Mini-CEX if the consultation will provide an

opportunity to complete an assessment applicable to their training program

requirements. Registrars may wish to consider organising their Mini-CEX for the last booking of the day, to allow adequate time for feedback.

While real-time observation is preferred, especially of junior registrars, Mini-CEX assessments may also be conducted by video. Registrars must gain consent from the patient prior to videoing the consultation. The assessor and registrar then review the video together, with the assessor pausing the video to provide relevant feedback and complete the assessment form. Videos should be reviewed within the same week of the original consultation.

5.1.1 The Mini-CEX Form

The Mini-CEX form can be downloaded from the College website at

www.acsp.org.au

The assessment criteria for each item include: