School of Surgery Induction Day <Date> ISCP Session

1. School of SurgeryInduction Day<Date>ISCP Session

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

3. 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

4. Trainee benefits Mandates: • Consistent training experience • Interaction with trainer • Educational feedback from trainer • Training of trainers • Clearly defined syllabus • Portfolio of evidence

5. 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

6. 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

7. Supervision Multi-professional Team

8. ISCP Website

9. Dashboard prompts

10. Trainee profile

11. Placements

12. Learning Agreement

13. Learning Agreement • Objective setting • Interim Review • Final Review • AES Report

14. Syllabus

15. Syllabus skill levels

16. Core Knowledge Texts

17. Assessment system Determines whether trainees are meeting the standards of competence

18. 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

19. 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

20. 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)

21. 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

22. 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

23. 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

24. 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.

25. 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

26. 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

27. 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

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

29. 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

30. 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