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

Outline1. What are the requirements for Intern assessment in 2014?2. Why do we assess interns?3. What is your role in intern assessment?4. How does general registration relate to internship?5. What is the AMC’s role in internship?6. 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/Registration-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 registrationby 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

Example: 2.2 .Communicate clearly, sensitively and effectively with patients, their family/carers, doctors and other health professionals.

Rating Descriptor

5 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

4 Performance level between 5 and 3

3 Communicates effectively in routine situations, but some difficulty in adapting communication to deal with challenging situations

2 Performance level between 3 and 1

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 Form

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

AMC Intern Outcome Statement (e.g. Domain 1 Statement 1.2)

Issues related to specific outcomes statement

Actions/Tasks

Responsibility Timeframe Review Date

Supervisor comments on the outcome of remediation:

• Located at the end of the Assessment formThe IPAP

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