Workplace Based Assessment (WBPA) For GP Trainees – What You Need To Know
If you’re a GP trainee and want to understand how you are assessed through WBPA (workplace based assessment) then this blog is for you!
Introduction
In August 2020 the Royal College of General Practitioners (RCGP) updated their guidance of workplace based assessments for GP trainees. New assessments were introduced for Trainees to complete as part of attaining MRCGP in GP training.
WBPA is 1/3 of your MRCGP assessment (alongside AKT and SCA) – and is definitely not to be taken lightly. In this blog I will go through the new changes and what you need to complete for each year of your training, to help you achieve MRCGP, and ultimately CCT.
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What is WPBA?
Workplace based assessments is defined by the RCGP as a way to ‘evaluate the trainee’s progress in areas of professional practice best tested in the workplace’. WPBAs are underpinned by the following principles:
- A tool to look at a trainee’s clinical performance in order to gather evidence for learning and reflection based on their daily working experiences.
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Looks at key learning points related to capabilities with patient safety in mind
Enables trainees to learn from constructive feedback as well as highlight those trainees that may need more support -
Assesses professional behaviour in a manner that the RCGP exams cannot assess
Helps determine if a trainee is suitable for CCT (Certificate of Completion of Training)
There are a series of assessments, done whilst in your normal working rotations, that help to demonstrate the necessary evidence required to complete training. We will touch on the main assessment types below.
What are the new WPBA changes?
In August 2020 the RCGP introduced 4 new assessments – CATs, Prescribing assessment, Leadership activity and Leadership MSF and QIP.
Except for QIP the other 3 assessments are to be completed in the ST3 year of GP training. QIPs can be completed in a GP post and can replace the need for QIA (quality improvement activity) to be completed if a QIP is completed in that year of training- you only need to demonstrate one quality improvement exercise a year.
The other main change is that ‘competencies’ have been replaced with ‘capabilities’ to suit the new curriculum – something that we’ll cover in more detail below.
WBPA numbers for each GP training year
In ST1 and ST2 you will be expected to complete the following assessments for satisfactory progress at ARCP:
- 4 mini-CEX/COTs
- 4 CBDs
- 1 MSF (10 responses)
- 1 CSR
- 36 case reviews
- CEPS ongoing
- 1 QIP (during GP post)
- 1 QIA if no QIPs
- 1 LEA/SEA
- 1 interim ESR
- 1 ESR
- 1 Placement Planning Meeting
In ST3 you will be expected to complete the following assessments for satisfactory progress at ARCP:
- 7 COTs
- 5 CATs
- 2 MSF (1 MSF and 1 Leadership MSF after Leadership Activity)
- 1 PSQ
- CEPS (5 mandatory and others)
- 36 case reviews
- 1 Leadership activity
- 1 Prescribing review
- 1 LEA/SEA
- 1 QIP
- 1 Interim ESR
- 1 ESR
- 1 Placement Planning Meeting
In addition to WBPA you will be expected to complete the following as mandatory training:
- Child Safeguarding – at least level 3
- Adult safeguarding – at least level 3
- Hands-on Basic Life Support (BLS) or Advanced Life Support (ALS) and Automated External Defibrillation (AED) use.
Overview of each assessment
Mini-CEX (mini consultation evaluation exercise) – these assessments are to be completed in secondary care only and are based on someone viewing and assessing a real life interaction between you and a patient
COTs (clinical observation tools) – these are completed in primary care (GP) placements and are used in these settings instead of Mini-CEXs. These also include Audio COTs as well to reflect the increased use of remote consulting. Again they are based on assessment of a ‘live’ consultation.
CBDs (Case based discussions) – these assessments are based around your professional assessment regarding a case and how this matches against the capabilities. It is in the form of a post consultation discussion (ie after the consultation or patient interaction has happened).
CATs (Care assessment tool) – these cover more areas than a CBD and could include a discussion around a post prescribing assessment follow up. Other examples might be a random case review or referral review. They are only used in primary care placements and again involve a discussion with your supervisor after an event or consultation.
CEPS (Clinical examination and Procedure skills) – these assess you against the 5 mandatory examinations needed as a GP trainee. They can also be used to demonstrate a range of other examinations or procedures you have learnt throughout your training.
MSF (multi-source feedback) – asking team members to feedback on yourself. You will need 10 responses; usually 5 non-clinical members and 5 clinical team members.
PSQ (patient satisfaction questionnaire) – asking patients to feedback on yourself and your consultation skills eg. have you shown empathy or developed a rapport with them. Patients are asked to rate you against 9 questions and 34 questionnaire responses are needed.
Leadership activity – this is an activity where you have demonstrated leadership eg. taken up a leadership role in your VTS or representing your trainee colleagues at the LMC. Other examples can be found on the RCGP website
Leadership MSF – asking colleagues to mark your leadership skills against 5 key areas – more information on RCGP website.
Prescribing Assessment – this involves you looking back at your own prescribing (50 retrospective scripts) and reflecting on any prescribing errors. A supervisor will then look at a sample of scripts and complete the assessment.
QIP – Quality improvement Projects are to be completed in a primary care post only. These are more detailed than audits – examples can be found on RCGP website.
Clinical Supervisor Report (CSR) – a short post-rotation report commenting on your performance during a particular post – GP or hospital – and how it has linked to the capabilities. Completed by your clinical supervisor – ie. your supervisor for that particular rotation such as a consultant paediatrician, GU consultant or GP in an ST1 primary care post.
Educational Supervisor Report (ESR) – all trainees will have an annual ESR and an interim ESR (at 6 months). Trainees are expected to reflect and add to their PDPs (click here to see example PDPs), as well as map their learning logs and assessments to the 13 capabilities. An ESR is used as a base of your ARCP (annual review of competency progression).
New WBPA programme
For each learning entry or assessment, you will be able to link them to clinical experience groups and clinical capabilities. There are 9 clinical experience groups and 13 clinical capabilities (previously known as competencies). It is important to link these correctly so that when it comes to your end of year review with your supervisor, you can clearly demonstrate a wide range of evidence across the curriculum.
The 9 Clinical Experience Groups are:
- Infants, children and young people (under the age of 19 years)
- Gender, reproductive and sexual health (including women’s, men’s LGBTQ, gynaecology and breast)
- People with long term conditions including cancer, multi-morbidity, disability
- Older adults including frailty and/or end of life
- Mental Health (including addiction, alcohol and substance misuse)
- Urgent and unscheduled care
- People with health disadvantages and vulnerabilities
- Population Health and health promotion (including people with non-acute and/or non-chronic health problems)
- Clinical problems not linked to a specific clinical experience group
The 13 Capabilities are:
- Fitness to Practice
- Maintaining an ethical approach
- Communication and Consultation skills
- Data gathering and Interpretation
- Clinical examination and Procedural Skills
- Making a diagnosis/decision
- Clinical management
- Managing medical complexity
- Working with colleagues and in teams
- Maintaining performance, learning and teaching
- Organisation, Management and Leadership
- Practising Holistically, promoting health and safeguarding
- Community orientation.
Summary
It is easy and common to feel overwhelmed when understanding and completing your portfolio, as well as adjusting to new rotations and preparing for exams. Planning is very important – what are your targets or goals and how you intend to achieve each of these goals. If done properly then your WBPA programme does not need to be stressful.
If you want any more details around each of these topics there are more resources on the RCGP website.
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Author Bio — Dr Aman Arora
Hi! I’m Dr. Aman Arora, a Portfolio GP with over a decade of clinical and teaching experience, dedicated to helping doctors achieve their goals with confidence. Having had the privilege of supporting more than 50,000 doctors worldwide across exams such as MRCGP AKT, SCA, MSRA, PLAB 2 and PLAB 1, I understand the challenges you face and the strategies needed to overcome them. Through personalised face-to-face sessions, engaging online courses, mocks, audio and a vibrant social media community, we’re here to guide you every step of the way.
Whether you’re looking to pass crucial exams or take the next big step in your medical career, we’re here to help you succeed. Feel free to get in touch with any thoughts, questions, or ideas — I look forward to working with you and being part of your journey.
Author Bio — Dr Pooja Arora
Dr Pooja Arora is a GP with a background in Medical Politics, where she passionately focuses on improving the opportunities and working conditions for junior doctors. She is proud to hold FRCGP (Fellow of Royal College of General Practitioners).
You can find out more about Pooja’s previous roles and qualifications here.
