This web-based portfolio, developed by the JRCPTB and in line with regulations outlined by the Gold Guide, provides a record of progress through training and the acquisition of competencies based on the relevant curricula. The e-Portfolio includes facilities for direct recording of SLEs, records of appraisal, ES reports and ARCP outcomes. Within HEE KSS, all trainees including LATs must maintain the NHS e-Portfolio as evidence of learning and progression.
The e-Portfolio is designed with three purposes in mind:
- as a learning tool for trainees
- to assist with educational supervision
- as a central source of information for all those involved in training
It is the trainee’s responsibility to ensure that their e-Portfolio is kept up to date; this includes recording reflections on learning and progress through the curriculum by linking to appropriate documentation and providing evidence of the competencies achieved. The content of the e-Portfolio feeds directly into the ARCP and ultimately, the final sign-off for CMT.
Access and enrolment
A temporary e-Portfolio account is created by the School of Medicine at KSS upon appointment to a training post and is managed locally by members of the Trusts’ Postgraduate Centres. The temporary account will be active for three months, during which time trainees must enrol with the JRCPTB.
To enrol please go to the JRCPTB website and follow the steps as outlined below. If, after three months, the trainee has failed to enrol, then the e-Portfolio account will be locked until enrolment has been completed. Once you have been issued with an account, you will be sent a username and password by the JRCPTB.
It is the responsibility of the trainee to keep up-to-date accounts of their teaching and experience and to ensure that sufficient numbers of assessments are completed. On the e-Portfolio, trainees must ensure all details on the profile are correct, in particular email address, postal address and GMC number.
Curricula describe the competencies required by a trainee during each training year, closely based on Good Medical Practice.
All competencies must be supported by evidence. Each competency must be signed off by the trainee’s Educational or Clinical Supervisor and must be supported by evidence. This will ensure that the e-Portfolio is packed full of evidence and reflects the trainee’s clinical and other activities.
This evidence is based on SLEs, log entries, audit, teaching attendance, other educational events, trainee’s own teaching, conferences, research, etc. In addition, trainees should complete the self-assessment for each competency and support their comments with evidence they feel is relevant to support any sign off.
Trainees are responsible for arranging their own assessments. They must ensure they do enough SLEs – there are minimum requirements for each ARCP and Interim Review stage, but trainees are advised to do more, in particular ACATs, to build up evidence for their competencies.
Trainees should ensure their SLEs are done by the most senior doctor, preferably a consultant or associate specialist, with a minimum of 50% assessed by a doctor in one of these grades. Trainees must have their assessments done by a variety of people.
Supervised Learning Events (SLEs)
Regular SLEs are conducted throughout training, building on those used in the Core Programme, these include:
- Mini Clinical Evaluation Exercise (mini-CEX) – this is a workplace based method where direct observation of trainees’ clinical skills during an everyday clinical encounter is assessed. These skills include medical interviewing ability, communication, and clinical judgement – but they vary depending on the specialty.
- Case-based Discussion (CbD) – this is a discussion that generally takes place in a reasonably formal setting, centred on a trainee’s reflection on his/her patient notes. The discussion will bring out key messages of a trainee’s knowledge, case management, diagnostic skills and planning etc. A CbD might be included as part of case presentations at department meetings, dependent on the specialty.
- Directly Observed Procedural Skills (DOPS) – this is a clinical encounter evaluating the trainee’s competence in a particular procedure, for example central line insertion, tracheal intubation or primary sutures.
- Acute Care Assessment Tool (ACAT) – this is applicable to all grades from CT1 to CCT. ACAT is an observed take, measuring 8 domains – for example clinical assessment, record keeping and handover. The ACAT is trainee led and takes no more than 15 minutes. This is a formative assessment and is used in medical specialties only. The assessment must be undertaken by a consultant.
- The MSF is a tool used to assess generic skills such as leadership, communication and team working; for this tool to work effectively trainees should have at least 12 respondents for it to be meaningful. It is an expectation that a minimum of one third of MSF contributions come from consultants. Other assessors could include: senior trainees and experienced nursing and allied health professional colleagues.
- Trainees must also ensure that their links to the curricula are signed off by ES in order to verify their learning. The supervisor can do this by accessing a trainee’s e-Portfolio, going to the curriculum and selecting and rating the trainee on each competency that they have linked. Please note that this is a very time consuming task and should not be left to the last minute.
- Trainees should record any absences from work on their e-Portfolio – this will be cross-referenced with medical staffing records. This is further mandated by trainee’s sign off of their probity and health declarations. Therefore all absences for reasons of sickness/compassionate leave, etc. must be communicated by the trainee to medical staffing to ensure their records are accurate.
- Quality improvement project (audit) is important, audit activity needs to be demonstrated, most importantly evidence of completion of an audit cycle.
- Remember to use the e-Portfolio to demonstrate areas of excellence – quality evidence and quality documentation are important.
The e-Portfolio Support Team at the JRCPB can be contacted via email: ePortfolioteam@jrcptb.org.uk. Please note that e-Portfolio queries should be directed to your Trust Medical Education Team in the first instance.
Penultimate Year Assessment
The Penultimate Year Assessment (PYA) acknowledges the successful completion of training for SpRs/StRs and thus enables trainees to begin applications for consultant posts. The PYA will take place between 12 and 18 months of your CCT date and is a mandatory requirement for all trainees seeking a Certificate of Completion of Specialty Training.
As the Acute Internal Medicine programme offers dual certification in General Internal Medicine, trainees will be required to undertake a PYA for each specialty. Approximately 12 to 18 months before your CCT date, the Medical Workforce team at the Deanery will notify you of the date of your Penultimate Record of In Training Assessment (RITA), i.e. your PYAs.
The RITA/PYA panel will consist of members of the STC including the Head of School, Training Programme Directors and College Tutors. In addition, an external assessor will be also be present to assess whether your training is on track for completion of your Acute Medical training. It should be noted that a PYA is not a pass/fail examination but an opportunity for the Deanery and the external assessor to ensure that you have met all curriculum requirements necessary; and have sufficient time available to complete the outstanding training before being recommended for your CCT. Approximately eight weeks prior to your PYA, you will receive notification from the JRCPTB about the documentation required for review at your PYA.
This will include a copy of your CV and a complete Summary of Clinical Experience (SOCE) form, and will need to be returned to the JRCPTB 4 weeks before the scheduled PYA date. This information will be presented to the external assessor prior to the scheduled date to ensure that the assessor is fully briefed on your training status before meeting with you. Once your PYA has been completed, you will receive a letter from the JRCPTB notifying you of your confirmed CCT date; and you will also receive a copy of the external representative’s report.
This will enable you to plan the remainder of your training in accordance with the recommendations made by the PYA panel and external assessor. For further guidance on PYAs please visit the JRCPTB website provided.
Specialty Certificate Examinations
All trainees who commenced specialty training on or after 1st August 2007 will be required to sit the Specialty Certificate Examination (SCE). The SCE is an examination usually undertaken any time from ST4 onwards and is a compulsory component of assessment for Certificate of Training (CCT) and Certificate of Eligibility for Specialist Registration via the Combined Programme route (CESR(CP)). It is strongly recommended that StRs allow sufficient time for at least two attempts at the SCE before they reach their anticipated CCT date. There is no limit to the number of attempts you may make at the SCE during your training. For further details on this examination, please visit the JRCPTB website.