Guide to Intern Assessment
Processes for Supervisors
• This PPT has been developed with the support
of CPMEC and primarily authored by Debbie
Paltridge, Alison Jones and Carmen Crawford.
• We would like to acknowledge the reviewers
of the material for their valued contribution’s
Outline
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What are the requirements for Intern assessment in 2014?
Why do we assess interns?
What is your role in intern assessment?
How does general registration relate to internship?
What is the AMC’s role in internship?
What happens at the end of intern year Certification Process?
What do you need to know about the nationally available Assessment
Form?
How do the assessment processes link to the Australian Curriculum
Framework for Junior Doctors (ACF)?
What are the next steps to support implementation?
What are the requirements for intern
assessment in 2014?
What are the requirements for intern
assessment in 2014?
• Refer to new national registration
standard: http://www.medicalboard.gov.au/R
egistration-Standards.aspx
• New requirements:
– Standard requiring assessment against intern
outcome statements (2014 transition)
– National form for certifying interns’ completion
(mandatory from 2014)
– Term assessment form (resource available from
2014)
Why do we assess interns?
Why do we assess interns?
• Patient safety
– To assist in decisions made about delegation and
independence of practice
• Interns are provisionally registered and require
supervision and education
• Clinical oversight
– To improve workload management
• To assist in directing intern learning and clinical
experience
• To make decisions about intern progression
What is your role in intern
assessment?
What is your role in intern assessment?
• Providing a snapshot of information on the
intern’s performance
– Gathering information from people who have seen
the intern perform
– Direct observation of the intern in the workplace
• Providing timely feedback to promote
development of the intern’s knowledge, skills and
attitudes
What is your role in intern assessment?
• Identifying an intern with performance issues
– Assisting in remediation of those issues
– Recognising when issues need to be escalated
and referred to DCT/DPET/MEO/DMS
How does registration relate to
internship?
How does registration relate to internship?
• Interns are granted provisional registration by the
Medical Board of Australia (MBA) to complete the
intern year
• The intern year is a period of supervised clinical
practice.
– At least 47 weeks of supervised practice in accredited
terms (core terms of medicine (10 weeks)/surgery (10
weeks)/emergency medical care (8 weeks) and other
non core accredited terms)
How does registration relate to internship?
• After satisfactory completion of the intern year,
interns can apply to the MBA for general
registration
– The Medical Board will consider the totality of advice in
deciding whether to grant general registration.
– An intern who has performed marginally or
unsatisfactorily in a specified term but who has
demonstrated ‘significant’ progress with evidence of
remediation may be deemed to have met
the standard expected for general registration
by the end of the year.
What is the AMC’s role in internship?
AMC role in internship
• Accredits medical training programs for the Medical Board of
Australia
• Developed standards, guidelines and forms for a national
internship framework
• Developed a nationally consistent assessment process based
on:
– Intern Outcome Statements (aligned with the graduate outcome
statements for medical schools)
– Medical Board of Australia Requirements for Certification and Sign off,
and
– A nationally available Term Assessment Form linked to the Intern
Outcome Statements
• AMC Prevocational Standards Accreditation Committee
oversees national intern standards
What happens at the end of intern
year certification process?
What happens at the end of intern
year certification process?
• DMS/DCT/DPET considers all term reports
– Can be assisted by an Assessment Review Group (if
needed)
• Written confirmation whether the intern
has:
– Satisfactory term supervisor reports
– An overall satisfactory rating
– Determination of any additional remediation
required e.g. additional time in core
terms
What is the end of year Certification
process?
• Assessment Review Group:
–
–
–
To assist with more complex decisions on
remediation
Chaired by a senior clinician with experience in the
education and training of interns and include;
employer representatives and relevant educators.
Should have clear and transparent procedures for
deciding on any course of action and for resolving
disputes and appeals.
So what do you need to know about
the Nationally Available Assessment
Form
Before you start
• You need to be aware that the form is only a
tool to facilitate assessment
• Assessment requires you to:
– Be familiar with the assessment requirements
– Determine how you are going to gather
information to inform your decisions
– Ensure the intern is aware of the assessment
processes you will be undertaking
The Assessment Form
• Based on the Intern Outcome Statements
• Uses a 5 point scale with descriptors
– Research shows improved reliability of this
approach particularly in large groups of assessors
– Descriptors will guide you to provide an authentic
rating of the trainee’s performance
– Three descriptors have been developed for each
Intern Outcome Statement (ratings 1, 3 and 5)
• Not observed option
The Assessment Form
• Example: 2.2 .Communicate clearly, sensitively and
effectively with patients, their family/carers, doctors
and other health professionals.
Rating Descriptor
5
4
3
2
1
Communicates effectively in routine and difficult situations: actively listens,
demonstrates appropriate language for the audience (patients, families or other
health professionals) and checks for understanding
Performance level between 5 and 3
Communicates effectively in routine situations, but some difficulty in adapting
communication to deal with challenging situations
Performance level between 3 and 1
Rarely communicates effectively: does not actively listen, cannot adapt language
to the audience and rarely checks for understanding
The Assessment Form
• After you have rated each of the intern outcome
statements you will be required to make a Global
rating of their performance on this term
• In making this rating you need to consider the
their ability to:
– practise safely;
– work with increased levels of responsibility;
– apply existing knowledge and skills and learn new
knowledge and skills as required
The Assessment Discussion
• Provide regular feedback throughout the term
and consolidate this at your mid and end of term
discussions
• Ensure you and the intern are clear about what is
being assessed and why
• Ask the intern what they need feedback on
(encourage them to refer to the ACF capabilities)
• Consider the intern’s self assessment ratings
where completed
• Discuss your assessment decisions, drawing on
the descriptors
What if you have identified some areas
that the intern needs to work on?
• Identification of performance issues needs to
occur as early as possible within the term.
• Where the intern is rated at a 2 or below and a 3
in some instances an Improving Performance
Action Plan (IPAP) is required.
• This should be developed in consultation with the
DCT/DPET and the intern
The IPAP
• Located at the end of the Assessment form
AMC Intern
Outcome
Statement
(e.g. Domain
1 Statement
1.2)
Issues
related to
specific
outcomes
Actions/
Tasks
Responsibility
statement
Supervisor comments on the outcome of remediation:
Timeframe
Review
Date
How do the assessment processes
link to the ACF?
How do the assessment processes
link to the ACF?
• The ACF is currently used to:
– Guide formal education programs provided to
PGY 1s and PGY 2s
– Outline the term experiences
– Assist interns’ self reflection on their experiences
– “what have I learnt on this term?”
How do the assessment processes
link to the ACF?
• The Intern Outcome statements have been
mapped to the ACF domains
• The ACF provides more detailed information
to describe the breadth of learning
experiences the intern may have
• The ACF is a good tool to use in your
assessment discussions
Next steps to support implementation
What are the next steps to support
implementation?
• Familiarise yourself with the form
• Ask your DCT or MEO any questions you may
have about the process
• Ensure your interns are comfortable with the
process
• Provide feedback on the process to your MEOs
to inform any future developments
Any Questions?
Summary
• Implementation of any new process takes
some time for everyone to become familiar
with the changes
• Intern assessment is everyone’s responsibility
• The assessment form is one part of the
process
• Supervisors play a crucial role in the
development of interns