School of SurgeryInduction Day

<Date>

ISCP Session

Overview

• ISCP aims and benefits• Roles and responsibilities• ISCP website• Learning Agreements• Syllabus• Assessment and logbook• Reflective Practice• The ARCP

ISCP Aims

• Structured and supervised framework with definable endpoint

• Clear standards• Fully integrated assessment system• Approved by SACs and the GMC• Promote professionalism• Patient safety and improved care

Trainee benefits

Mandates:

• Consistent training experience

• Interaction with trainer

• Educational feedback from trainer

• Training of trainers

• Clearly defined syllabus

• Portfolio of evidence

Trainee responsibilities

• Engage with the ISCP• Takes responsibility for own learning• Triggers WBA frequently• Exploits learning opportunities• Attends educational programme• Undertakes the learning agreement with the AES• Raises issues and difficulties promptly• Conducts self-directed learning• Keeps an accurate and up to date portfolio

Trainer responsibilities

• Undertakes training and is qualified for the task• Engages with the ISCP• Provides induction and supervision• Ensures consent and patient safety in relation to

trainee performance• Provides appraisal to curriculum standards• Monitors progress, mentors and guides• Assesses, provide formative feedback, validates

assessments• Reports on progress• Identifies concerns and addresses issues

Supervision

Programme Director

Assigned Educational Supervisor

Trainee

Clinical Supervisor

ISCP Website

Dashboard prompts

Trainee profile

Placements

Learning Agreement

Learning Agreement

•Objective setting•Interim Review•Final Review•AES Report

Syllabus

Syllabus skill levels

Core Knowledge Texts

Assessment system

Learning Agreement

Assigned Educational Supervisor (AES) Report

Workplace-Based Assessment + LogbookAoA CEX / CBD / DOPS / MSF / OoT / PBA

Courses: ATLS / APLS

Annual Review of Competence Progression (ARCP)

MRCS Examination FRCS Examination

Determines whether trainees are meeting the standards of competence

WBA methods

• Clinical Evaluation Exercise - CEX• Case Based Discussion – CBD• Direct Observation of Procedural Skills – DOPS• Multisource Feedback - MSF• Procedure Based Assessment – PBA• Observation of Teaching – OoT• Assessment of Audit – AoA• Non-Technical Skills for Surgeons - NOTSS

WBA principles

• Assessments for learning• Trainee driven • Also trainer guided: the number, type, setting, level etc.

should be agreed with your AES as part of the LA• Standard is at the end point of a stage • Mapped to the curriculum• Forms prompt dialogue and capture feedback.• At least 40 WBAs per year. • The portfolio contributes to AES overall assessment for

the ARCP• Assessment of professionalism

CBD

• Uses medical records as the basis for a structured discussion to explore knowledge, judgement and clinical reasoning in the management of challenging cases.

• Covers a range of clinical problems relevant to the stage of training and the specialty.

• Includes reflective writing.• Assessed by the AES, Clinical Supervisors, other consultants

and senior StRs • Takes about 15-20 minutes for discussion of the case and 5-

10 minutes for feedback• Appropriate settings include case presentations, outpatient

clinics, A&E (especially if not admitted)

CEX

• Observed trainee-patient clinical encounter• Evaluates the trainee’s ability to take a history, examine,

reason, organise and communicate• Assessed by the trainee’s current AES, other consultants,

senior StRs and staff grades and other senior health care professionals

• Takes about 15-20 minutes for the discussion and 5-10 minutes for feedback

• Appropriate settings include clinic, breaking bad news in planned settings, ward, A&E, Dealing with a patient/relative who has a complaint

DOPS

• Observed short, diagnostic and interventional procedures during routine surgical practice

• Covers patient safety, preparation, operative technique, communication and documentation

• Available for most index procedures in core training • As training progresses DOPS are superseded by PBAs• Assessed by the trainee’s current AES, other consultants, senior

StRs/staff grades and other senior HCP• Takes about 15-20 minutes for the discussion and 5-10 minutes for

feedback• Settings include ward, out-patients, A&E, theatre

PBA

• Observed assessment of advanced index procedures. Usually in theatre, scrubbed.

• Covers patient safety, consent, pre-operative planning and preparation, exposure & closure, intraoperative technique and post-operative management

• Assessed by the current AES, other consultants and in some specialties, senior StRs depending upon level and the complexity of the procedure.

• Takes about 10-15 minutes for the discussion and 5-10 minutes for completion of the form

MSF

• Uses the trainee’s self-assessment and the collated ratings from a range of members of the multidisciplinary team from different grades and settings

• Evaluates clinical care and professionalism in a team-working environment, mapped to the standards of Good Medical Practice.

• One MSF in each year of surgical training. • The current AES must be a rater.• Trainee chooses at least 12 (minimum 8) from different grades• Raters need to have read the guidance notes form.• Takes approximately 5-10 minutes to complete the form.• Trainee must meet with the AES to discuss the feedback and complete

the process.

Teaching & Audit

Observation of Teaching• Assesses trainee’s formalised teaching• Assessors can be any doctor with suitable experience

Assessment of Audit• Provides feedback on trainee’s completed audits, when

submitted for review• More than one assessor should take part• Assessors can be any surgeon with appropriate expertise

WBA process

• Agree with the assessor in advance• Ensure assessor is trained in the tool and expert in the task• Draw on different assessors, settings and cases• Ensure patient safety and consent• Prepare and reflect in advance• Make sure your assessor gives you feedback• Upload ratings as soon as possible with your own comments• Reflect on your feedback and undertake any actions• Ensure your assessor validates your assessment

Surgical elogbook

https://www.elogbook.org/

• Registration required• Record of all operative procedures• Builds a record of operative experience• Records level of involvement and supervision level• Respect for confidentiality of colleagues and patients• Consolidated reports can be viewed within the ISCP

Logbook levels

• Observed (O)• Assisting (A)• Supervised – trainer scrubbed (S-TS)• Supervised – trainer unscrubbed (S-TU)• Performed (P)• Training more junior trainee (T)

Reflective practice

• Purposeful use of experience to improve practice• Requirement of the curriculum • Evidence section• WBA comments• MSF Self-assessment• Case-Based Discussion (CBD) reflective writing• Personal Development Plan• Journal• Must respect confidentiality of colleagues and patients

ARCP

• 40 WBAs of different types linked to Learning Agreement• MSF • Evidence section – exams, courses, projects,

publications, research etc.• Audit / Quality Improvement project • Surgical logbook • Clinical Supervisor comments• Learning Agreement • AES Reports • JCST trainee survey