Workplace-Based Assessments in Psychiatry

242 Pages·2011·2.58 MB·English

by  Dinesh Bhugra

It has now been 4 years since significant changes were made to &m
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the way psychiatric trainees’ skills are assessed for the MRCPsych rl
examinations. Much teaching, learning and assessment now ittlik, b
occurs in the workplace in real clinical situations, with the eh
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This book outlines the workplace-based assessments (WPBAs)
that are required by the current competency-based psychiatry
curriculum. It has been updated, taking into account the
experience gained since these assessments began. The authors
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explore the theory and practice of different assessment methods
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such as case-based discussion, long-case evaluation and directly r
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observed practice, changes in the MRCPsych examinations and p
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The second edition includes new chapters on Direct Observation a
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of Non-Clinical Skills (DONCS), educational supervisor reports, the e
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new online portfolio for trainees, workplace-based assessments

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in psychotherapy and views from trainees themselves. This book s assessments
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will be essential reading for psychiatric trainers and trainees. e
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About the editors m
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Amit Malik is a Clinical Services Director in Hampshire and was integral to the n
development and implementation of workplace-based assessment tools in the ts
UK. He successfully led the national implementation of electronic systems for in
WPBAs and portfolios.
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Dinesh Bhugra is Professor of Mental Health and Cultural Diversity at the
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Institute of Psychiatry, King’s College London, and an Honorary Consultant at c
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the South London and Maudsley NHS Foundation Trust. He has been influential ia
in psychiatric training and assessment in the UK, particularly as Dean (2003– t
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2008) and President (2008–2011) of the Royal College of Psychiatrists. y edited by
Andrew Brittlebank is Deputy Medical Director for Medical Performance at amit malik, dinesh bhugra
Northumberland, Tyne and Wear NHS Foundation Trust and Associate Dean
for Postgraduate Education at the Royal College of Psychiatrists. His areas of & andrew brittlebank
College responsibility include curriculum and workplace-based assessments.
PUBLICATIONS
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Workplace-Based
Assessments in Psychiatry
Second edition
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Workplace-Based
Assessments in Psychiatry
Second edition
Edited by Amit Malik, Dinesh Bhugra
and Andrew Brittlebank
RCPsych Publications
© The Royal College of Psychiatrists 2011
RCPsych Publications is an imprint of the Royal College of Psychiatrists,
17 Belgrave Square, London SW1X 8PG
http://www.rcpsych.ac.uk
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form
or by any electronic, mechanical, or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or retrieval system, without permission
in writing from the publishers.
British Library Cataloguing-in-Publication Data.
A catalogue record for this book is available from the British Library.
ISBN 978 1 908020 06 2
Distributed in North America by Publishers Storage and Shipping Company.
The views presented in this book do not necessarily reflect those of the Royal College of
Psychiatrists, and the publishers are not responsible for any error of omission or fact.
The Royal College of Psychiatrists is a charity registered in England and Wales (228636) and in
Scotland (SC038369).
Printed in the UK by Bell & Bain Limited, Glasgow.
Contents
List of tables, boxes and figures vii
List of contributors ix
Preface xi
1 Introduction: changes in training 1
Amit Malik, Dinesh Bhugra and Andrew Brittlebank
2 Workplace-based assessment methods: literature overview 14
Amit Malik and Dinesh Bhugra
3 Case-based discussion 28
Nick Brown, Gareth Holsgrove and Sadira Teeluckdharry
4 The mini-Assessed Clinical Encounter (mini-ACE) 45
Nick Brown
5 The Assessment of Clinical Expertise (ACE) 56
Geoff Searle
6 Multi-source feedback 68
Caroline Brown
7 Direct Observation of Non-Clinical Skills: a new tool to assess
higher psychiatric trainees 76
Andrew Brittlebank
8 Workplace-based assessments in psychotherapy 84
Chess Denman
9 Educational supervisor’s report 99
Ann Boyle
10 Portfolios 108
Larissa Ryan and Clare Oakley
11 Annual Review of Competence Progression (ARCP) 122
Wendy Burn
12 Examinations in the era of competency training 131
Anthony Bateman
v
contents
13 Piloting workplace-based assessments in psychiatry 142
Andrew Brittlebank, Julian Archer, Damien Longson, Amit Malik
and Dinesh Bhugra
14 Developing and delivering an online assessment system:
Assessments Online 154
Simon Bettison and Amit Malik
15 A trainee perspective of workplace-based assessments 167
Clare Oakley and Ollie White
16 Conclusions 181
Amit Malik, Dinesh Bhugra and Andrew Brittlebank
Appendix 1: Assessment forms 185
Appendix 2: Guide for ARCP panels in core psychiatry training 197
Appendix 3: The MRCPsych examination 215
Index 218
vi
Tables, boxes and figures
Tables
14.1 A blueprint for a mini-ACE assessment (example) 50
18.1 Case-based discussion (CbD) group assessment form 88
18.2 Supervised Assessment of Psychotherapy Expertise (SAPE) 94
13.1 Satisfaction scores and time taken to complete the first
6 months of WPBAs 146
Boxes
11.1 Methods for the assessment of trainees’ performance 6
13.1 Structured question guidance 36
13.2 Helpful prompts for planning a case-based discussion 37
13.3 Case-based discussion: clinical record-keeping performance
descriptors 38
13.4 Case-based discussion: clinical assessment (including
diagnostic skills) performance descriptors 38
13.5 Case-based discussion: medical treatment performance
descriptors 39
13.6 Case-based discussion: risk assessment and management
performance descriptors 39
13.7 Case-based discussion: investigation and referral perform-
ance descriptors 39
13.8 Case-based discussion: follow-up and care planning
performance descriptors 40
13.9 Case-based discussion: professionalism performance
descriptors 40
13.10 Case-based discussion: clinical reasoning (including
decision-making) peformance descriptors 40
13.11 Case-based discussion: overall clinical care performance
descriptors 41
vii
tables, boxes and figures
14.1 mini-ACE: history-taking performance descriptors 51
14.2 mini-ACE: mental state examination performance
descriptors 51
14.3 mini-ACE: communication skills performance descriptors 52
14.4 mini-ACE: clinical judgement performance descriptors 52
14.5 mini-ACE: professionalism performance descriptors 52
14.6 mini-ACE: organisational efficiency performance descriptors 53
14.7 mini-ACE: overall clinical care performance descriptors 53
15.1 ACE: history-taking performance descriptors 62
15.2 ACE: mental state examination performance descriptors 63
15.3 ACE: communication skills performance descriptors 63
15.4 ACE: clinical judgement performance descriptors 63
15.5 ACE: professionalism performance descriptors 64
15.6 ACE: organisational efficiency performance descriptors 64
15.7 ACE: overall clinical care performance descriptors 64
16.1 Good Medical Practice and mini-PAT domains 71
19.1 Portfolio evidence 105
19.2 Key areas to be explored with an underperforming trainee 106
10.1 Important factors for portfolio success 112
10.2 Utilising the Royal College of Psychiatrists’ Portfolio
Online 118
11.1 Example of a remedial plan for a trainee who has failed
the CASC examination 127
13.1 General Medical Council’s standards for curricula and
assessment systems 143
14.1 Nielsen’s top ten usability heuristics 162
14.2 Typical support enquiries 164
Figures
13.1 Case-based discussion planning grid 35
17.1 Skills assessed in the DONCS pilot study 81
18.1 A grid for systematically recording a complete
psychological formulation of a patient’s difficulties 98
10.1 Kolb’s learning cycle 109
viii