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Naturally Occurring Evidence (NOE) in ePortfolio

 

Unlike work placed based assessments (CbDs COTs etc) the NOE expectations for SEA and case presentations are pro-rata for part timers, though you are expected to round up to next whole SEA or case presentation!

 

Please be aware that there are extremely strong reasons for recommending this approach to producing good evidence and that is why as a Deanery there is a strong recommendation that you use this format.

 

The NOE that we expect are intended to help trainees and educational supervisors access good evidence. Most trainees struggle to produce good evidence of many competencies, especially the teaching element of Maintaining Performance, Learning and Teaching, Fitness to Practice, Community Orientation and Working in Teams. So the NOE expectations are framed either to enable trainees to provide evidence of these or to ensure that the RCGP Certification Unit can sign you off for CCT (hence the expectations about leave). To find out more about how we would expect you to provide links you may want to view the following page: Naturally Occurring Evidence and displaying your competencies

 

The South Yorkshire Locality is carrying out a trial of using a booklet which has the recommended evidence pulled into one word document and one excel spreadsheet. It is expected that this will make it easier for trainees and educational supervisors to complete and that by putting an explanation of which competencies each component is intended to cover and adding some prompts to the standard ePortfolio questions it is even easier to provide evidence that is useful for demonstrating competencies. This approach will be evaluated in the summer of 2012. In the meantime the SYLO workbook and spreadsheet have been added at the following link for anybody who would like to use them:

 

1. Significant event analysis:

  • File under Significant Event Analysis in your ePortfolio
  • 3 SEAs in every six month post (or 2 in every four month post)
  • Please complete these as soon as possible after the event as it is best to allow the educational supervisor to look at big events like these promptly
  1. A significant event should have significant personal involvement; it is suggested that there is balance between SEAs which focus on individual learning and those which deal with team issues and improving systems of care. The format we require is being used to support appraisal for GPs and  is part of the QOF framework, so you will be learning important skills for the future.
  2. A significant event (also known as an untoward or critical incident) is any unintended or unexpected event, which could or did lead to harm of one or more patients
    This includes incidents which did not cause harm but could have done, or where the event should have been prevented.
  3. ALL patient safety related SEA’s (formerly known as SUIs) need to be recorded as part of your NOE to comply with the narrower GMC definition of SEA used for Revalidation. You are currently required (see below under Other Essentials) to declare any SUIs or Critical Incidents – and the description of the incident should be recorded in the ePF under SEAs and given a title of SUI

 

 

2. Reflection on key learning points from each post:

  • File under Courses/Certificates
  • 1 in every 6 month post

Concise summary of learning points, including reflections on learning achieved (in terms of knowledge, skills and attitudes), and how this relates to a career in GP.  This reflection will result in new learning objectives for next posts.  (Expected length up to one page A4).

 

3. Audit or Reflection on QOF:

  • File under audit/project
  • During the first GP attachment either an audit or reflection on a QOF area should be completed

Normally this should be done in the first GP attachment and be available for the ARCP panel within four months of completion of the first GP post.  There is no requirement from the ARCP for a further audit during ST2 and ST3


The purpose of this exercise is to engage the trainee in change management in the practice in order to improve the quality of patient care. Audit is referred to by the GMC as part of Good Medical Practice, it is an expectation of re-validation and it is specifically referred to as being an expected part of training in the GP curriculum
The Audit should demonstrate a complete cycle.  The trainee may need to take one day study leave from a hospital post to return to the practice to do a second data collection - expecially if the first post is four months.
A copy of the audit should be uploaded as an attachment to the learning log entry and a good quality learning log entry will demonstrate appropriate reflection on the audit
QOF reflection. Choose one quality indicator – e.g new QOF indicator or one where performance is sub optimal. Examine and clarify the issues with reference to literature including suggestions to improve performance


If you attend an audit or QOF meeting and you record these in your learning log, you should file them under lecture/seminar, because you should reserve the audit/project heading for audits etc that you personally carried out.

 

4. Case study or presentation

  • File under Lecture/Seminar
  • 1 in every 6 month post

This can be a presentation of a clinical case study, literature review, a research project, a discussion paper or notes review; such a presentaton may have been given in a departmental setting or VTS group
Key points considered in the assessment of this work are:

  • discussion of how practice relates to the evidence base
  • demonstration of relevance to career in GP
  • Consideration of the teaching approach used

Remember, if you do a departmental or VTS presentation, this can be mapped to curriculum statement 3.7; teaching, mentoring and clinical supervision.
(A set of power point slides with no discussion or reflection will be judged inadequate)

 

OOH Requirements in GP Post

Expected OOH Experience

As completing your out of hours sessions is a contractual requirement, there are fitness to practice issues if this is not done, as well as issues linked to failure to gain the RCGP defined minimum experience

  • File under Out of Hours
  • One out of hours session per month in general practice placements are considered the minimum exposure for the registrars (pro-rata).  So doctors doing 18 months in GP will need to complete 108 hours of OOH experience
  • Phone triage is acceptable for part of out of hours experience
  • The registrars educational supervisors are expected to check the number of OOH sessions during the formal review of the ePortfolio.
  • You must keep a record of your hours and submit this to your ARCP panel review when it is due: Log of Out of Hours form

 

Your Leave and Complaints to date

The RCGP certification unit will not be able to process an application for a CCT unless they have confirmation of any leave taken in addition to the annual leave that is allowed. For this reason we need to have clear and available recording of this so that trainees avoid delays in receiving their CCT

  • File under Professional Conversations

All trainees should be keeping a log of their leave to date and any complaints that have arisen during their training period.  These need to be submitted to ARCP panels when your review is due (i.e. when moving from ST1 to ST2, ST2 to ST3 and ST3 to CCT)

 

Other Essentials

  • File under Professional Conversations

All trainees need to keep a log of the following continuously throughout their training period and submit these to the ARCP panel review meeting when it is due

  • Incidents - Complaints - GMC referral form
  • Statement / summary of GP release attendance (time taken to attend the release course is paid time, there is therefore a potential probity issue if a trainee does not attend the expected percentage of release course meetings for their posts)