Work Place Based Assessments (WPBAs) and the E-Portfolio

The WPBAs and the e-portfolio play an extremely important role in attaining the MRCGP and this fact should not be under-estimated!  They account for one third of the MRCGP assessment (along with the AKT and CSA).

From August 2013 the e-portfolio has a new look.  It may take a little time to get used to the new lay out for current trainees.  The examples below use the “old” lay out – the principles, however, are about the same.  We will update these in the coming weeks (once the e-portfolio is working!!).

RCGP e-portfolio login page

Learning Log

The learning log forms the backbone of your e-portfolio.  It gives your clinical and educational supervisor the chance to see how you reflect and learn from your experiences.

Here in Barnsley we expect a minimum of 4 learning log entries per week when you are in General Practice and 2 learning log entries a week when you in a hospital post.  We are aware that this amount varies between different training schemes.

Learning Log Headings

There are a number of headings that you can choose from.  For example,  every six months period you will have to do 3 Significant Event Analyses (SEAs) and there is a heading for this.  You might put a meeting with your educational supervisor under “Professional Conversation”.

Nb. We recommend that at least 50% of your entries are “Clinical Encounters”.  These are often the best way of showing us what you have learnt and achieved.  This then allows us to assign the RCGP Competencies.

Curriculum Linkage

Every time you add an entry, whatever heading it comes under, you are able to “link” the entry to one of the RCGP curriculum headings by clicking on “select descriptor”.  Knowing how to link your entries can be tricky at first.  Try and think what significant areas have been covered and then link to these.  You may notice that you can only link to a maximum of 3 headings.

Nb.  we expect that as you progress through your training you gradually build up the number of log entries you have under each descriptor.  Certain descriptors always cause trainees problems i.e. genetics, learning disabilities, eye problems and ENT, facial and oral problems.  Whenever you get the chance to add an entry to one of these “hard to reach” areas it is worth making that extra effort in the long run.  Once again there is no standard minimum amount of log entries, however, by the time of your final ARCP panel in ST3 we would expect the number of entries for each descriptor to be in double figures.

Your educational supervisor will link to your entry to the Competency Curriculum – this is different to the RCGP curriculum statements/descriptors.  You are more than welcome to enter log entries in order to provide evidence that you have achieved the set competencies.

Remember to share your entries when you have completed them!

What makes a good learning log entry?

It is really important that however many learning log entries you add to your e-portfolio they are of a good quality.  So what is a “quality” learning log entry?  In 2010 the RCGP produced some guidance on this, which can be found here.  We have also given you some examples to give you some sort of rough idea of what we may expect from you.

Example of a “good” learning log entry

This would be a reasonable entry for a “Clinical Encounter” where the focus by the trainee is on the clinical aspect of the entry.  They have identified a learning need and stated by when that would be completed – they have not stated how it would be completed though.

Example of a “poor” learning entry

Overall, this entry lacks detail.  A bit more background and context would have been useful.  Were there any other relevant findings on examination? What was the patient’s expectations ?  What was the diagnosis and what evidence is there to suggest that antibiotics were warranted in this situation?  With regards the learning need, “consider” makes it sound as though the trainee already knows about other causes of ear discharge, so I would have suggested “learn about …” and to go away and do the appropriate reading.

In some ways writing a quality learning log entry is a skill like any other and will improve as you do more.  It is really important to give your supervisors an insight into what you are thinking and your thought processes.  Tell us what you struggled with and how you could have done things differently.  What did you learn?  This could be a single piece of useful clinical information or a staggering, earth-shattering revelation, which changes how you practise medicine!

Learning Needs

We would expect the majority of learning entries to generate learning need i.e. there was something you were not too certain of and you need to find out more about it.  It is important to let us know what this need is, how you are going to go about achieving it (i.e. reading, discussing with colleagues etc) and when you expect this to be completed (this will typically be week, possibly months but not years!).

Sharing

When you have finished a learning log entry you have the option of “sharing” it.  This will then allow your educational supervisor to read and comment on your entry.  Please read and answer any comments.

Personal Development Plan

Personal Development Plan (PDP)

Although your PDP does not form any formal part of the assessment process it is mandatory that you have one.  Your PDP should be a statement of what you would like to achieve.  The objectives should be set at the start of each six month post and would normally be completed during that time period.  There may be some objectives which one would expect to compete over a much longer time period.  There is no minimum amount of entries required by either the RCGP or the Deanery, however we would strongly advise that you have at least five of six entries for every six months job.

Trying to decide what sort of objectives you put in your PDP can be difficult.  It is important to consider a number of aspects before you commit yourself.

Example of a PDP entry

“I will learn about respiratory illness in General Practice”

Think “SMART”:

i.  Be SPECIFIC.  The above entry is far too broad.  It would be impractical to try and fit the entire RCGP curriculum on respiratory illness into a single entry.  A more appropriate entry might be to focus on specific illness such as Asthma or COPD, or a symptom i.e. shortness of breathe or cough.

ii.  The M stands for MEASURABLE.  By this we mean how do you, and your educational supervisor (ES), know that you have achieved your goal; what measure (proof) are you going to use?

Taking Asthma as an example, you might have as one of your aims “to be able to manage a patient with an exacerbation of acute asthma”.  Often what trainees write when they first start is that they will know this aim has been achieved because “I will be able to manage a patient with an acute exacerbation of asthma” – unfortunately this does not really tell your ES whether or not you are able to manage a patient with an acute exacerbation of asthma.  A more measurable action may be “I will complete a COT (or Mini-CEX) where I manage a patient with an acute exacerbation of Asthma” or “I will enter a learning log entry reflecting on…”.

The bottom line is that whatever “measure” you use it has to be more substantial than just stating you are able to do something.

iii.  Make sure that your objectives are ACHIEVABLE.  We do not expect you to know everything there is to know about Asthma, however we would expect you to know about the symptoms and signs of asthma, appropriate investigations, being able to interpret the results and the management of asthma in primary care.  Make sure whatever you put add to your PDP you can realistically achieve.

iv.  Make your objectives as RELEVANT to you as possible.  The PDP is for your development.  Take into account that “relevant” is not an excuse for avoiding topics or areas that you do not like.  Every trainee will have areas of the curriculum they are less keen on but will be important for when you are an independent GP.

v.  For every objective you will need to set a dead-line (TIME-BOUND) by when the objective (and supporting evidence) would have been completed.  For the most part this would be by the end of each 6 month job, however you may have a small number of objectives which go beyond 6 months.

Note:

We would not advise adding objectives to your PDP that are mandatory requirements i.e. passing the AKT/passing the CSA or mandatory DOPS – you have to do this anyway!

You should have the majority of your PDP objectives entered within the first couple of weeks of starting each new job and you should complete them in a timely manner.  It is very useful if you signpost your supervisors to the relevant evidence which supports completion of your PDP (see the example below):

If you are still confused there are a number of other GP Trainee websites with useful information on PDPs: Pennine GP Training Scheme and the London Deanery or ask us for advice at the training afternoon on wednesday.

Significant Event Analysis

Significant event analysis (SEA) is now a routine part of primary care.  As GP trainees in Barnsley you will be expected to record three SEAs every six months in your e-portfolio.  Within the learning log there is a specific SEA heading which can be assigned to your log entry.  We try and organise one session every six months to discuss and share SEAs.  We do feel that it is appropriate for trainees to use other people’s SEAs as long as they add their own personal reflection.  We would only advise using a shared SEA for one of three SEAs that we expect you to complete.

For more detailed guidance on how to write up an SEA please click the following link to the deanery website.