Guide to Intern Assessment
Processes for Interns
• 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
1.
2.
3.
4.
5.
6.
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?
7. What do you need to know about the nationally available
Assessment Form?
8. How do the assessment processes link to the Australian
Curriculum Framework for Junior Doctors (ACF)?
9. What are the next steps to support
implementation?
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 level of
supervision
• To fulfil legal requirements
– Doctors with provisional registered are required to practise
under supervision before being granted general
registration
• Clinical oversight
– To improve workload management and ensure patient
safety
• To assist in directing intern learning and clinical
experience
• To make decisions about intern progression
What is your role in the assessment
process?
What is your role in the assessment
process?
• As an intern you are:
– an active participant in your learning throughout
internship
– actively involved in arranging mid and end of term
assessment meetings with your supervisor
– encouraged to actively seek feedback on specific
aspects of your performance.
– both willing and able to receive feedback on your
performance
– asked to regularly make honest judgements about
your performance
– actively involved in the assessment discussion
and any plans for remediation
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 do you need to know about the
Nationally Available Assessment form?
Before you are assessed
• Be aware that the form is one part of the overall
assessment process
• Ensure that you are prepared for the assessment
discussions
– Be familiar with the assessment requirements
– Reflect on your performance (both personally and
through gathering information from others) and
complete the form from your perspective
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 your assessors to provide an
authentic rating of your 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
• There is also a Global rating of your performance
on the term
• In making this rating the supervisor will consider
your 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
• You should receive regular feedback throughout the
term and consolidate this at your mid and end of term
discussions
• Ensure you are clear about what is being assessed and
why
• Be willing to tell the supervisor what you need
feedback on
• Consider your self assessment ratings
• Discuss your supervisor’s assessment decisions,
drawing on the descriptors in the form
• Refer to ACF to determine areas you would like
feedback on
What if your supervisor identifies
some areas that you need to work on?
• Welcome the opportunity to get guidance on
how to perform at a higher level
• Familiarise yourself with the IPAP process:
– Where you are rated at a 2 or below and a 3 in some
instances an Improving Performance Action Plan
(IPAP) is required.
• Work with your supervisor and DCT/DPET to
develop this plan
• Ensure you are clear on the next steps and
actions required of you
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
both PGY 1s and PGY 2s
– Outline the term experiences
– Assist interns self reflection on their experiences –
“what have I learnt on this term?”
How does 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 and process
• Understand that your supervisors are familiarising
themselves with the new process too
• If unsure, ask your DCT/DPET or MEO any questions
you may have about the process early
• Provide feedback on the process to your
MEOs/DCTs/DPETs to inform any future
developments
• Actively prepare for your assessment meetings with
your supervisor
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
• Active involvement by you will ensure that you
get the most out of this process