Form

Initial in-practice performance assessment

Registrar name:

Supervisor name:

Semester:

Please make an assessment of your registrar’s performance. You, and your supervision team, are recommended to use a range of assessment activities that must include observation of your registrar consulting. It is recommended that you observe or parallel consult at least 6 consultations.

1.Please indicate what tools you used to make your judgments

Tool

/

Tick if used

/

Indicate level of use – e.g. number of consultations

One of these modes MUST be used / Direct observation (sitting-in or video review)
Wave/parallel consulting (see reference)
Additional modes / Review of registrar’s clinical notes and referrals
Case discussion
Discussion with other practice members
Other:

2.Please complete the following assessment sheet (please see Addendum C for explanatory information)

Question / Judgement / Comments
Yes / No / Unsure
Does the registrar have foundational clinical skills and knowledge? / / /
Does the registrar communicate effectively? / / /
Does the registrar recognize the limit of their competency and seek appropriate advice? / / /
Can the registrar recognise the sick patient and respond appropriately? / / /
Does the registrar exhibit empathy and rapport? / / /
Does the registrar prescribe appropriately? / / /
Question / Judgement / Comments
Yes / No / Unsure
Does the registrar make appropriate referrals? / / /
Does the registrar effectively engage other practitioners and services? / / /
Can the registrar prioritise and manage their time? / / /
Is the registrar professionally responsible in their clinical practice? / / /
Does the registrar understand and respect professional boundaries? / / /
Does the registrar accept and learn from feedback? / / /

3.Global judgement of the registrar’s performance

It is ESSENTIAL that this section is completed only AFTER reviewing Addendum A and Addendum B.

Please tick one (1) box.

Judgement / Tick one (1) box
  1. The registrar has demonstrated a capacity to consult independently accessing supervisor support when required.
/
  1. The registrar requires close oversight of their consulting that is manageable within the resources of the practice.
/
  1. The registrar has competency deficits that require further assessment and management by MCCC.
/
Please provide some written comments that provide a summary of how you have arrived at your global rating. This is particularly important if you have chosen option 2 or 3.
What specific learning goals have been identified for the registrar from this assessment?

Addendum A

Red Flags
Please review the following ‘red flag’ indicators. If you tick any of these boxes, please tick 3 for your Global Judgement (previous page) and notify your regional Senior Medical Educator (SME).
Behaviours
Not punctual, or unjustified absences
Unprofessional behaviour
Behaviour that falls within the AHPRA “notifiable conduct” criteria
Intelligibility and comprehension issues (in regard to either spoken or written English)
Clinical Practice
Not seeking advice
Excessive need for assistance
Chaotic thinking
Major knowledge gaps
Lack of clinical skills
Serious misdiagnosis or mismanagement
Teaching and Learning
Poor attitude to teaching program
Ineffectual response to feedback
Lack of responsibility
Orange Flags
Please review the following ‘orange flag’ indicators. A tick in any of the following may indicate an issue requiring your intervention / action. If the identified issue does not improve following your intervention / action, please notify your sub regional SME.
Behaviours
Poor administrative preparation for the term
Inappropriate clothing
Relating poorly with practice staff
Rigid opinions
Clinical Practice
Lack of clinical skills
Consistency prescribing outside of accepted best practice
Needing rescuing from failed procedure
Poor time management
Poor consultation notes
Poor referral patterns
Orange Flags
Please review the following ‘orange flag’ indicators. A tick in any of the following may indicate an issue requiring your intervention / action. If the identified issue does not improve following your intervention / action, please notify your sub regional SME.
Teaching and Learning
Not asking questions
Asking excessive questions
Poor attitude to teaching program
Lack of progress
Complaints
Patient complaints
Staff complaints
Complaints from external providers

Addendum B: Reflection on personal biases

Please consider possible biases. E.g. halo, leniency, severity, etc. Below is information to assist you in identifying these. Please refer to this before making your final judgement below.

The research on judgmental measures of performance has revealed several systematic tendencies to rate in certain directions; called rating effects. Please take some time to reflect on your personal biases and consider whether your biases have influenced your ratings. Amend your ratings if you this is necessary.

  • Do I tend to be stringent or lenient? How has this impacted on my assessment of the registrar?
  • Are there personal characteristics about the registrar that tends my judgement one way or another?
  • What are my “hobby horses” (a preoccupation or favourite topic)? Have these come into play in the judgement of the registrar?
  • Are there recent experiences that make me more attune to particular competencies? Have these impacted on my judgement of the registrar?

Addendum C: Explanatory Information

This information will also assist you to complete this process.

The purpose of the initial assessment process is to collect information about the registrars’ areas of strength, learning needs and capacity to perform at an expected PRRT1/GPT1 level through a range of relevant activities.

The information will be used by the education teams to guide the registrar’s early learning journey, including the level of supervision and support, and to assist in the registrar’s development of a relevant plan for learning.

The link below details the competencies of junior doctors. There is an expectation that registrars commencing in your practice should meet these as a minimum.

Link to Australian curriculum framework for junior doctors:

Foundational Clinical Skills and Knowledge

History taking:

  • Elicits history of the presenting problem with an appropriate systems review. Awareness for the biopsychosocial issues.

Physical Examination:

  • Conducts a focused physical examination and with correct technique.

Referrals and investigations:

  • Orders and interprets investigations

Diagnostic Skills and Recognition of the acutely ill patient:

  • Recognises and effectively assess the acutely ill, deteriorating or dying patient (of any age group).
  • Synthesizes clinical information and generates an appropriate list of differentials.
  • Discriminates between the possible differential diagnoses relevant to the presenting problems or complaints.
  • Synthesizes information and problem solves at a level of simple complexity. Uses the hypothetico-deductive method for problem solving.

Management Skills:

  • Makes decisions (though not always sure or confident).
  • Takes appropriate steps to manage serious illness.
  • Adequately informs patients.
  • Addresses basic lifestyle issues.
  • Manages acute emergency presentations: asthma, anaphylaxis, seizures, chest pain and AMI, shock, poisoning, overdose, envenomation, and haemorrhage.
  • Has a patient centred approach?
  • Actively promotes illness prevention and health improvement.
  • Considers the impact of psychosocial problems on health.
  • Prescribes medications using evidence based guidelines.
  • Refers to other specialist practitioners based upon sound clinical evidence.

Procedures:

  • Able to do: CPR, ECG, IM injections, suture of simple lacerations but see also:

Australian curriculum framework for junior doctors – skills and procedures:

  • The need for particular procedural skills will depend on the Practice as well as what the GPR believes are important skills for him or her to have.

Communication Skills (establishing rapport):

Has effective communication skills and in particular:

  • Is warm and sympathetic.
  • Is easy to talk to and establishes rapport.
  • Appears self-confident.
  • Listens and responds to verbal cues.
  • Uses language that is clear and easily understood, and
  • Communicates effectively in the written word (clinical notes and referral letters).

Recognition of limit of their competencies and accept feedback:

  • Willingness to learn and improve.
  • Adapts to different work and clinical situations.
  • Is reflective.
  • Has self-awareness (including awareness of limitations).

Professionalism and working as part of a team:

  • Works in a team (practice staff as well as colleagues).
  • Commitment to General Practice and the patient are essential from the beginning.
  • Self-care and attention to work-life balance is also very important.
  • Compliant with medico-legal requirements.
  • Advocates for the patient.
  • Behaves professionally at all times and with all people (respect, boundaries, duty of care, confidentiality).
  • Understands and complies with the principles of: justice, beneficence and non-maleficence, patient autonomy and confidentiality.
  • Recognises and manages appropriately, situations where the “culture” of the doctor and the “culture” of the patient are in conflict.
  • Is willing to extend oneself and to be challenged.
  • Readily identifies learning needs.

Organisational Skills including time-management:

  • Has a good work ethic and an organised approach.
  • Self-directed – takes responsibility for their learning as well as the development of their learning plan.
  • May have difficulty with time-management (this is expected at this stage and allowances are made).
  • Has basic computing skills.

Initial in-practice performance assessment v1.1 29.01.2016.doc

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Form

Initial in-practice performance assessment

Appendix 3: Early Supervisor Report

From AGPT (2014) MMI Interviewer Training.

Initial in-practice performance assessment v1.1 29.01.2016.doc

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Form

Initial in-practice performance assessment

Addendum 4: References

Wave consulting

DeWitt, D. E. (2006). Incorporating medical students into your practice. Australian Family Physician, 35(1/2 January/February), 24-26;

A YouTube clip by Dr Peter Stevens

Wearne, S., & Brown, J. (2014). GP supervisors assessing GP registrars – theory and practice. Australian Family Physician, 43(12), 887-891 is a further resource for the whole process.

Initial in-practice performance assessment v1.1 29.01.2016.doc

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