TE14

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1.   INTRODUCTION

In-training assessment (ITA) of Trainees in Anaesthesia is an essential part of the Trainees’ education. It complements other methods of evaluation, such as the College’s examinations. ITA is a joint process of evaluation and goal setting by the Trainee and the Supervisor of Training (SOT), and requires active participation by the Trainee. It is essential that the assessment is conducted in accordance with sound educational principles, and that the principles of natural justice are observed.

The College’s ITA follows a formative process only. Formative assessment is personal and aims to be supportive of the Trainee.

2.   OBJECTIVES

The objectives of ITA are to:

2.1   Assess and assist with the Trainee’s progress towards appropriate goals.

2.2   Provide regular feedback to Trainees.

2.3   Develop any remedial activities for the Trainee that may be required.

However, the failure to fully achieve the objectives will not invalidate the process.

3.   PROCESS

3.1   It is the responsibility of each Trainee to maintain his or her Learning Portfolio throughout training. It should include originals or copies of formal documents related to training as well as voluntary documentation such as a log-book. It MUST contain the original signed copy of the ITA – 2 form from each final assessment with a SOT, and SHOULD contain all self evaluation of performance forms.

3.2   Formal assessment meetings must occur between the SOT and each Trainee at the beginning (the initial interview) and end (the final interview) of each six month period (or sooner if the term is less than six months). Trainees can initiate these meetings. Additional meetings between the Trainee and SOT should occur as appropriate. There should also be regular group meetings between the SOT and the Trainees together with the Head of Department if appropriate.

3.2.1   Any Trainee experiencing difficulty should bring this to the attention of the SOT as early as possible.

3.2.2   The initial interview between the SOT and the Trainee will review the Trainee’s previous performance, and set appropriate goals for the next training term. This will involve review of the Trainee’s Learning Portfolio, and self evaluation, which is to be completed using an ITA – 1 form. The SOT will contact other SOTs if necessary to assist with this process.

3.2.3   At the final assessment interview, the SOT and Trainee will review and discuss the trainee’s performance during the completed attachment.

3.3   The formal assessment of the Trainee’s performance over the previous attachment should be based upon:

3.3.1   An assessment by the three senior staff who are best placed to provide that assessment. Each must complete an ITA – 1 form, and/or:

3.3.2   An assessment by a consensus meeting of the senior staff of the Department in writing using an ITA – 1 form.

3.3.3   The SOT should use this information to complete the ITA – 2 form. Prior to the final interview, the Trainee should be asked to complete an ITA – 1 form as self evaluation. This information will be used to discuss the past term and to establish goals for the next one. The ITA-2 form must be signed by the Trainee and the SOT, after the Trainee has had an opportunity to add comments.

(The signature is to confirm receipt of the ITA, it does not necessarily indicate acceptance of all its contents).

If the Trainee is continuing at the same institution for the following six months, then the final interview should be joined with the initial interview for the next term.

3.4   The signed original copy of the ITA – 2 form will be retained by the Trainee, along with any self evaluation forms the Trainee completed, and inserted into the Trainee’s Learning Portfolio.

A copy of the signed ITA – 2 form should be submitted to the Regional Education Officer (REO) by the SOT within two weeks of the assessment.

The REO will review these forms to ensure completeness of the documentation before forwarding them to the College where they will form part of the Trainee’s central record.

3.5   The following points may assist senior staff and SOTs in situations where the Trainee’s performance is not at the level indicative of a satisfactory assessment.

3.5.1   If there is a performance less than that “consistent with level of experience” in any of the skills/attitudes/abilities listed on the ITA-2 (indicative of a consensus view of the senior staff involved), then this matter must be discussed with the Trainee with a view to establishing remedial strategies. An isolated “unsatisfactory” attribute does not necessarily constitute an unsatisfactory assessment.

3.5.2   A consistent unsatisfactory attribute over more than one assessment or multiple unsatisfactory attributes on the one occasion must be discussed with the Trainee and remedial strategies drawn up. The Trainee should be told in writing that his/her future performance will be specially monitored, and planning for the next term should take that requirement into account. It may be advisable to consult with the hospital’s human resources department at this time.

3.5.3   Continued performance during serial assessments which is less than “consistent with level of experience” may be indicative of a situation which should be discussed with the Head of Department, with the REO, and reported to the Chief Executive Officer of the College.

3.5.4   Advice as to remedial strategies can be obtained through the REOs and from the Education Unit at the College.

4.   UNSATISFACTORY ITA PERFORMANCE

4.1   When a Trainee consistently performs at a level which is considered to be below that to be acceptable for a developing specialist anaesthetist, not withstanding repeated documented attempts at remediation, then the provisions outlined in College Professional Document TE18 Guidelines for Assisting Trainees with Difficulties section 7 should be considered. This will require that processes outside In-Training Assessment are invoked. Any serious errors or incidents affecting patient safety may also trigger a review of the Trainee and his/her performance.

4.2   If a satisfactory resolution cannot be achieved using the provisions of College Professional Document TE18 Guidelines for Assisting Trainees with Difficulties, further assistance can be obtained using the Trainee Performance Review.

4.3   Advice on both these processes can be obtained through the REOs and the College’s Chief Executive Officer.

5.   PRIVACY

Information collected in relation to Trainees will be held, used and distributed as provided in the College’s Privacy Statement and as permitted by law.

Ordinarily each ITA will only be considered by the College, and used for the purposes of the Training Program. It will not ordinarily be provided to the hospital/employer – unless the College believes it is appropriate to do so in the interests of patient safety, An ITA is not intended to be used for employment purposes, and is intended solely for use in the training program in accordance with the above objectives. ITAs may be shared with SOTs in subsequent rotations, especially to assist in the supervision, remediation and assessment of progress of Trainees.

COLLEGE PROFESSIONAL DOCUMENTS

College Professional Documents are progressively being coded as follows:

TE Training and Educational

EX Examinations

PS Professional Standards

T Technical

POLICY - defined as 'a course of action adopted and pursued by the College'. These are matters coming within the authority and control of the College.

RECOMMENDATIONS - defined as 'advisable courses of action'.

GUIDELINES - defined as 'a document offering advice'. These may be clinical (in which case they will eventually be evidence-based), or non-clinical.

STATEMENTS - defined as 'a communication setting out information'.

This document is intended to apply wherever anaesthesia is administered.

This document has been prepared having regard to general circumstances, and it is the responsibility of the practitioner to have express regard to the particular circumstances of each case, and the application of this document in each case.

Professional documents are reviewed from time to time, and it is the responsibility of the practitioner to ensure that the practitioner has obtained the current version. Professional documents have been prepared having regard to the information available at the time of their preparation, and the practitioner should therefore have regard to any information, research or material which may have been published or become available subsequently.

Whilst the College endeavours to ensure that professional documents are as current as possible at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently.

Promulgated as E14 1994

Reviewed: 2001

Date of current document: April 2007

© This document is copyright and cannot be reproduced in whole or in part without prior permission.

College Website: http://www.anzca.edu.au/