July 2014

  1. Supervisors have to assess curriculum competencies for the purposes of WPBA for three different areas:  When using assessment tools (COT, CBD and miniCEX), when writing a clinical supervisor’s report (CSR), and when writing an educational supervisor’s report ESR.  Trainees are expected to self rate within the ESR. The differences between the assessment for an ESR, CSR and an assessment tool are detailed below. 

  2. For the assessment tools (COTs/CBDs etc), there are 4 grades for assessing a competency: insufficient evidence, needs further development, competent and excellent. The competent level should always be the standard required for a fully qualified, independent GP in practice, ie. the standard for licensing.

  3. When writing an ESR, the GPST and ES makes an assessment of each competency area based on the evidence in the portfolio, as well as from the review discussion.  It will be expected for those in ST1 and ST2 attachments to “need further development” in most, if not all, areas but this can be divided into “Meets Expectations, Below or Above Expectations”. The GPST/ES needs to document against each competency the specific evidence used to make their judgement and also indicate what actions are suggested to develop further.  The “Fit for Licensing” rating in the ESR should only be used if the trainee has demonstrated this standard across a varied range of contexts and challenges and it is therefore not appropriate to use this rating in ST1/2.  If progress is above expectations, it can still be appropriate to add suggestions for further development – use of the word pictures under the “Excellent” heading can be helpful in these cases.

  4. The competency grades are designed to assess professional behaviour in day to day practice rather than just knowledge.  When doing each rating it is useful to calibrate oneself by looking at the word pictures, which can be found underneath each rating.

  5. NOTE that needs further development does not indicate incompetent, rather it indicates “has not reached the required level of competence for a qualified GP”.  It may indicate for example that the GPST has knowledge in a particular area, but has not adequately demonstrated its application in practice, or in a sufficient range of contexts or that the knowledge is not yet sufficient.

  6. In CBDs, if the GPST has not demonstrated the necessary performance/behaviours for a particular competency area, or displays “incompetence”, then they should be graded as insufficient evidence.  In the latter case it is very important to add free text comments in the feedback box.

  7. Insufficient evidence should also be recorded if a particularly competency area has not been assessed during an assessment, (eg either not discussed in a CBD, or not relevant in a COT).  The RCGP is aware that there may be some confusion over the fact that this grade is being used for two different purposes, and there may be changes in future.  A grading of excellent may be achieved where application of knowledge and behaviour demonstrates a high level of fluency and expertise (see below regarding the word pictures).

  8. When completing a COT or CSR, each competency should be assessed although for CBDs usually only 2-3 should be assessed.  It is possible to view word pictures which describe how to rate each competency by clicking on the blue link “click to display” - see also Competency Word Pictures (also know as WPBA Detailed Descriptors)

  9. For COTs and CBDs a competent grade should be given for behaviour/performance that contributes a piece of positive evidence towards a competency.  It follows that such a grade does not, in itself, state that full achievement of competence in that area has necessarily been achieved, as further development may still be required (in different or more challenging cases) - this is in contrast to the meaning of a competent grade in an ESR as detailed above.

  10. The CSR uses different competency clusters, and the supervisor is asked to rate the GPST against peers at the same stage of training with ratings of: “Below, Meets or Above Expectations”.