Oxford Deanery protocol for management of Summative Assessment failures
Background The aim of Summative Assessment is to identify those practitioners who are not yet ready for independent general medical practice. It is made up of four assessment instruments. Failure in any one of the assessment instruments results in Summative Assessment failure as a whole. It is sometimes possible to repeat these assessments during the training year, but often it will be necessary to apply for an extension in order to undertake the necessary training to maximise the chances of success in a repeat assessment. Very occasionally it will become apparent that the chances of success at a repeat assessment are so remote that the registrar is best advised to reconsider whether general practice is an appropriate career aim. The purpose of this protocol is to ensure consistency in the process that will be used when a GP registrar fails the MCQ, videotape, or audit components of Summative Assessment and, where possible, to provide standards against which the performance of the Deanery can be measured. If problems become apparent It is recognised that frequently problems that relate to the performance of the registrar will become apparent to the trainer and the training practice in ways other than through failure at a component of Summative Assessment. In these instances the trainer should always discuss the performance problems with the registrar. If the problems are severe, or if there is no improvement after discussion, the trainer is advised to discuss the problem as early as possible with the course organiser and the local associate director and to inform the Director of Postgraduate General Practice Education, who will discuss with the trainer the most appropriate way of investigating and managing the problems. Consequently, if a trainer is considering failing the Trainers Report component of Summative Assessment the registrar should already have received feedback about the areas of problem performance, and the problem will have been highlighted to the course organiser, associate adviser and Director of Postgraduate General Practice Education as early as possible. Principles This protocol is based on the following principles: The need to provide information to the GP registrar as soon as possible. The need to provide as much feedback as possible to the registrar about the performance problems that have resulted in failure. The need to provide sufficient information to ensure appropriate support for the registrar whilst maintaining appropriate levels of confidentiality. The need to base further training on a clear diagnosis of the cause of the problems and a clear educational plan to address the causes identified. The need to ensure that adequate time is available for the registrar to complete the educational plan. The need to follow up progress against that plan. The recognition that a registrar will need to have sufficient time to complete a resubmission (and that in the case of a videotape they will need to be seeing patients during this time to enable them to undertake the recording).   The Protocol ACTION STANDARD On receipt of notification of failure DPGPE (or Deputy) sends standard letter to GP registrar informing them of failure and indicating our intention to inform the trainer, course organiser (CO) and local associate adviser. DPGPE (or Deputy) gathers as much information as possible, including the causes and the views of the trainer and CO, to consider whether a period of extension is necessary and whether it is likely to be successful. Letter sent to the registrar within 2 working days of notification. Also copy to trainer, Course organiser and associate adviser When it is believed that a period of further training is desirable; (a) Informal extension: DPGPE or Deputy writes to offer extension GP registrar writes formally to accept extension (b) Formal extension – application made to JCPTGP for approval for extension for training – this will be the usual route for those who have undertaken summative assessment and failed a component. GP registrar writes to JCPTGP requesting additional training (including the application form which can be obtained from the JCPTGP, and any VTR forms relating to periods of training already completed) also enclosing: Written report from trainer on GP registrar ’s progress to date Written report from the DPGPE supporting the additional training If satisfied that further training will be of benefit, JCPTGP will write to GP registrar confirming arrangements GP registrar writes to DPGPE to accept extension of training, with copy of JCPTGP letter Letter to GPR re next stages within 2 weeks of original notification. Letter of support from DPGPE/Deputy within 1 week of notification from GPR of intention to apply to JCPTGP. Information on causes of failure is supplied to registrar, trainer, course organiser, and local associate director. Associate director meets with registrar, trainer and course organiser to:a. Identify nature of problems b. Develop an educational plan c. A key worker for implementing the plan (usually the trainer) will be identified. A key worker for monitoring the plan (usually the associate director and/or course organiser) will also be identified. d. The associate director provides a written record to the registrar, trainer, course organiser and DPGPE of the educational plan including plans for monitoring/follow up. Letter within 1 week of acceptance of extension by GP registrar. Meeting within 2 weeks of receipt of letter providing feedback. Written plan available within 1 week of meeting. Associate director/registrar /trainer maintain follow up. Meetings occur at frequency defined in plan. Registrars applying from other Deaneries for an extension to training If a trainer is approached by a registrar seeking to undertake an extension of training in the Oxford Deanery having undertaken their other training elsewhere the following protocol will apply: Trainer will inform local course organiser and local associate director and DPGPE. Trainer will seek information from previous trainer. DPGPE will seek information from previous DPGPE and pass on to trainer, course organiser and associate director. Trainer, course organiser and associate director will meet with the registrar to consider whether or not it is appropriate to appoint the registrar. If the appointment of the registrar is thought to be desirable the third component of the above protocol will then be followed.