SLEs and Assessments
Supervised Learning Events (SLEs)
The Malta Foundation Programme uses 4 types of SLEs which are summarised below:
1. Case-based Discussion (CbD) (Watch training video)
This is a structured discussion of clinical cases managed by the foundation doctor. Its strength is discussion of clinical reasoning.
- A structured discussion takes place of real cases in which the foundation doctor has been involved.
- Decision-making and reasoning can be explored in detail.
Feedback and debriefing
A key component of the assessment process is the provision of feedback and debriefing. This is required to outline the views of teachers/trainers to doctors in the Foundation Programme. Giving and receiving feedback, which highlight both success and difficulty, are a vital part of, and will enhance learning and development.
Teachers/Trainers may be Consultants, Resident Specialists, GP Specialists or Higher Specialist Trainees (HSTs).
2. Mini Clinical Evaluation Exercise (mini-CEX) (Watch training video)
This is an assessment of an observed clinical encounter with immediate developmental feedback. A minimum of six observed encounters suggested in both F1 and F2. Mini-CEX is one form of observed clinical encounter.
A different trainer should be used for each mini-CEX, wherever possible.
Teachers/Trainers may be Consultants, Resident Specialists, GP specialists or HSTs, and should ideally include the educational supervisor once.
Each mini-CEX should represent a different clinical problem, sampling each of the acute care categories listed in Section 4 of the Curriculum. The foundation doctor chooses the timing, problem and the trainer.
3. Direct Observation of Procedural Skills (DOPS) (Watch training video)
This is a structured checklist for assessing practical procedures. DOPS is another doctor-patient observed encounter
- Two observed procedures are suggested per placement.
- Different observers/assessors should be used for each encounter, wherever possible
Teachers/Trainers may be Consultants, Resident Specialists, GP specialists, HSTs, BSTs, suitable nurses or allied health professionals.
Each DOPS should represent a different procedure, sampling from the acute care skills listed in Section 3 of the Curriculum, or from procedures specific to the specialty. The foundation doctor chooses the timing, procedure and observer/assessor. Trainers may also carry out unscheduled assessments.
4. Developing the Clinical Teacher
This is an assessment of a foundation doctor's skill in teaching and/or making a presentation. This can be used for one-to-one teaching and group teaching.
Trainers must be trained in assessment and feedback methodology. They must be able to competently undertake the teaching session yourself.
Teachers/Trainers should be Consultants, Resident Specialists, GP specialists and experienced Higher Specialist Trainees. If possible, a different trainer should be used for each teaching assessment.
The process is led by the foundation doctor, who should choose the teaching session.
Developing the Clinical Teacher includes four rated question areas (see below) and provides free-text space for you to identify what went well, areas for development and an overall feedback of the teaching/presentation.
Besides the SLEs, trainees also have to perform a Multi-source feedback as part of their Assessment at the workplace. Trainees should send out electronic tickets via their e-portfolio to their colleagues so that they can be assessed on their behaviour at the workplace. The details can be found below.
Multi-Source Feedback (MSF)
Multi-source feedback - Team Assessment of Behaviour (MSF-TAB) was previously described as 360° assessment. These are collated views from a range of co-workers. MSF-TAB should usually take place twice a year, unless concerns are identified. The foundation doctor should nominate at least 10 raters/assessors for MSF-TAB. Most raters/assessors should be supervising Consultants (Clinical Supervisors), GP specialists, Higher Specialist Trainees (HSTs), Basic Specialist Trainees (BSTs) and experienced nursing or allied health professional (AHP) colleagues.
The following will apply for MSF from July 2010:
The Foundation trainee should send off 15 assessment requests.
Out of the minimum of 10 required responses, the raters must be:
- 2-8 doctors: must be at least one Consultant Clinical Supervisor / GP specialist; Preferably should include resident specialist, HST and BST from firm; no other foundation doctor
- 2-6 Nursing Officers (NO) / Deputy NOs
- 2-4 Allied Health-Care Professionals
- 2-4 other team (eg secretaries, PGC staff, ward clerks...)
It is recommended that one TAB is done toward the end of the first placement (usually September) and another TAB is done in the third placement (usually March). The TAB should be done within the same placement time interval. (E-portfolio will only group TAB responses for every 3 month placement)
Further important Assessments are done in the form of the Clinical Supervisor's report and the Educational Supervisor's report, both of which are done towards the end of every placement.