Assessments and appraisals
There will be regular appraisal and assessment during ACCS training which is both formative and summative. Progress at various points in is dependent on successful assessment. The timing and format of appraisal and assessment will vary for each specialty specific module and will be in accordance with the requirements specified in individual specialty CCT programmes.
Assessment system for the individual elements of Acute Care Common Stem, by specialty
- Successful completion of the Acute Care Common Stem (ACCS) and progression to the next stage of training requires satisfactory progress in all parts of the ACCS elements, regardless of the intended future career pathway i.e. level one competence in Acute Medicine (AM), passing the initial assessment of competency in anaesthesia and performing satisfactorily in those key areas identified by Emergency Medicine (EM) and Intensive Care Medicine (ICM).
- Each element requires a large number of assessments (typically 1-4 each month) and trainees should be strongly encouraged to complete assessments regularly throughout the programme. It is unlikely that it will be possible to complete all assessments if trainees leave this task until the end of their attachments.
- The assessment system is trainee driven and they should liaise closely with their trainers/educational supervisors regarding progress through the assessments.
- Assessments should ideally be supervised by trainers, but may on occasion be delegated to senior trainees (currently SpR4/5 and in future ST5/6).
Speciality Specific Competencies and Assessments
Each of the four specialities has certain specific competencies that need to be achieved during the module. For both Anaesthesia and Intensive care there are separate competency documents that you will be required to achieve in order to successfully complete your training. These competencies and assessments are a central part of your training in these specialities. The generic work place assessments (below) should be used as tools to assist in your training and to provide evidence for your portfolios.
Work Place Assessments
Trainees will be assessed in the workplace using a range of assessment tools to be completed by different (sometimes multi-professional) assessors. The assessment methods are described below and will be used in different ways by different specialties. The number of forms needed also varies by speciality and deanery. While completing the minimum number of assessment forms is one requirement for a successful outcome from the ARCP, it may be necessary to complete many more assessments in order to show competence throughout the curriculum.
- Mini clinical evaluation exercise (mini-CEX) - is a workplace based method where direct observation of a trainees clinical skills during an everyday clinical encounter is assessed. These skills include medical interviewing ability, communication and clinical judgment and vary depending on the speciality.
- Case based discussion (CbD) - is a discussion generally in a reasonably formal setting centred on the trainees reflection on his/her patient notes. The discussion will bring out key messages of trainees knowledge, case management, diagnostic skills and planning etc. A CbD might be included as part of case presentations at department meetings dependent on the speciality.
- Directly Observed Procedural Skills (DOPS) - is a clinical encounter evaluating the trainees competence in a particular procedure for example central line insertion, tracheal intubation or primary sutures.
- Multi Source Feedback (MSF) - is a version of the 360 degree assessment. A number of multidisciplinary raters anonymously score a trainee against a number of domains mostly concerned with attitudes and behaviours.
- Acute Care Assessment Tool (ACAT) - this is applicable to all grades from ST1 to their CCT. ACAT is an observed take measuring 8 domains for example clinical assessment, record keeping and handover. The ACAT is trainee led (choosing the take period and may be observed by an SpR/StR) and takes no more than 15 minutes. This is a formative assessment and is used in medical specialities only
The completion of the WPBAs and STRs is the trainees responsibility, if no documentation is produced for the ARCP it is very likely that the trainee will fail to progress.