Transcript The nMRCGP e-portfolio

The nMRCGP e-portfolio
What to put in?
Dr Andrew Ashford
Programme Director, West Essex
VTS
In this session …
We will consider (? reflect on): WHY an e-portfolio?
 WHO might look at it
 What makes you fit to practice?
 Writing “meaningful” entries
 Writing a PDP that works (for you!)
WHY an e-portfolio?
Simply…
The RCGP needs evidence of your fitness to
practice!
It is where “…the GPStR records their
learning in all its forms and settings”
Who will be looking at it?
Your trainer / educational supervisor
 The Deanery ARCP panel (yearly)

A
Patch Director or Director of GP training
 A Programme Director (PD)
 A lay member… yes, a member of the PUBLIC!
… and if things go very wrong, a committee
at the GMC (more lay members of the
public!)
SO… those looking in are
You
 Your immediate educational supervisors
and PDs
 PMETB & the Deanery
 The public

What would YOU want to see?
Competence?
“Brilliant with morphine, that Shipman
fellow!”
... But would you have trusted him to give
you some?
Competence?
Mr Slick is the rudest, most arrogant
surgeon I have ever met …
… but if I ever need a hemicolectomy I want
him operating on me and no-one else
A difficult balance
Within our profession:“Serious weaknesses in a doctor’s practice
are accepted if they are balanced by major
strengths”
(Liam Donaldson)
GMC Duties of a Doctor
“treating every patient politely”
 “listening to patients & respecting their
views”
 “keeping professional knowledge & skills
up to date”
 “recognising the limits for your
professional competence”

GMC Duties of a Doctor

“acting quickly to protect patients from
risk if you have good reason to believe
that you or a colleague may not be fit to
practice”
Recasts the definition of good medical
practice (Liam Donaldson)
Character?
Lovely guy, Mr Bodgit (FRCS) – kind, honest,
always does what he says he’ll do, tells it
as it is, wonderful bedside manner (etc)
... But I wouldn’t let him near me with a
scalpel
Fitness to practice
At a personal level this boils down in the
end to one thing…
Whether the public TRUST you to do the job
… are you TRUSTWORTHY?
Trustworthiness
Based on
 CHARACTER (what you are as a person)
 COMPETENCE (what you can do)
“If you have faith in my character but not in
my competence, you still wouldn’t trust
me”
(Stephen Covey)
Character and Competence

You need both!

Both can be evidenced in the e-portfolio
Evidence for character..?
Oh yes!
If you are frequently late, bunk off early,
let people down, or display “jobsworth”
attitudes…
 Your CSR reports will reflect this! (and
probably your PD will be calling you in for
some discussion)

Common difficulties
What makes a meaningful log entry?
 What the heck is a reflective entry?
 How do I do a PDP – and what should I
put into it?

Log entries
To start with …
START !
Anything is better than nothing (you won’t
be “failed” on it, and at least your ES can
give you some feedback!)
Quality not quantity
One good quality reflective entry may be
worth 20 poor / descriptive ones
…but aim for at least one clinical entry per
week
+ a tutorial / VTS half-day topic
+ something else
Covering the Curriculum

You cannot do this without regular log
entries!

The ARCP panel always looks at this!
FAIL!
Reflection

Observing the operations of ones own
mind (with a view to discovering deeper
truths about oneself)

Careful reasoned thinking – linking
personal experience to theories /
experiences of others
Reflection

Critical stance – what might be? – can I
improve on original?

Analyses / evaluates personal experience,
attempts to generalise / propose theories /
heuristics for future use
Gibbs’ model of reflection (1988)
Description
What happened?
Action Plan
If it arose again,
what would you do?
Feelings
What were you
thinking about?
Conclusion
What else could you
have done?
Evaluation
What was good &
bad about the
experience?
Analysis
What sense can you
make of the situation?
Johns 1994
Description

Write description of experience

What are the key issues
Johns 1994
Reflection
 What was I trying to achieve?
 Why did I act as I did?
 What are the consequences of my actions?



For the patient and family
For myself
For people I work with
How did I feel at the time?
 How did the patient feel about it?
 How do I KNOW how the patient felt about it?

Johns 1994
Factors influencing your decision-making
and actions
What internal factors influenced them?
 What external factors influenced them?
 What sources of knowledge did – or
should – have influenced them?

Johns 1994
Alternative strategies
Could I have dealt better with the
situation?
 What other choices did I have?
 What would be the consequences of these
other choices?

Johns 1994
Learning from the experience
 How can I make sense of it in light of past
experience & future practice?
 How do I feel NOW about it?
 Have I taken effective action to support
myself & others as a result of it?
 How has it changed my way of knowing in
practice?
What do we learn from?
Experientially in the workplace: Things that “could have gone better”
 Disasters & “near misses”!
 Things that went surprisingly well!
 Watching others do it well
 Watching others do it badly (and picking
up the pieces afterwards)
So ask yourself…
SO WHAT?
“How did I feel about this?” – and record it
“Did this force me to think differently about
my approach?”
“If so – WHY?
“What could/should I do differently next
time?” – specific action / mental approach
Examine successes too!

If something went surprisingly well, ask
yourself “WHY?” – tease out the reasons
or components

Then you – and others – can hopefully
replicate them in the future
NOW write your log entry

Aiming to demonstrate BREADTH of
experience and learning

But also DEPTH
A
few key “nuggets” which EVIDENCE your
learning
 Specific changes
What comments might the
Educational Supervisor add?
The PDP
WHY?
Essential component of NHS appraisal
 ARCP panel requires one! – to assess
“maintaining performance, learning &
teaching”

PDP – what is it?

A prioritised statement of your personal
learning needs for the year, and how you
propose to meet them

A living document!
What is ARCP looking for?
Evidence of – you’ve guessed it –
REFLECTION
PDP – SMARRT entries
S
M
A
R
R
T
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–
–
–
–
–
–
Specific
Measurable
Achievable
Relevant
REFLECTIVE
Time-limited
“Send to PDP”
If following boxes completed
“What further learning needs…”
 “How and when…”

E-Portfolio “Don’ts”
Not completing the log
 Writing about things that are nothing to
do with the curriculum
 Using the log as a place to air
discriminatory, slandering or extreme
views – the “rant”

How to meet the ARCP panel!
No PDP…
 No “minimum” WPBA assessments
 No OOH…
 No CPR cert…
 Poor quality entries (that don’t improve with
time)
 Little or no curriculum coverage
 … or just the unlucky 10% (quality control)
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Further reading
“Help” link L side e-portfolio
 RCGP Website
 Google “E-portfolio Tips and Wrinkles”
(S E Scotland Deanery)
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