A Guide to Core Psychiatry (CPT) Workplace Based Assessments ...

A Guide to Core Psychiatry (CPT) Workplace Based
Assessments (WPBAs) & ARCP
Competence Attainment
All trainees will have an Annual Review of Competence Progression (ARCP) organised by
their deanery. This is described in the Gold Guide and replaces the RITA process. The key
elements of this review are:
Appraisal
i. Educational
ii. NHS
Assessment of performance
i. Workplace Based Assessments (WBAs)
ii. Experience demonstrated e.g. from portfolio including audit, research and
other aspects of non-clinical competence
Planning
Achievement of competencies will be considered in the Educational Supervisor’s Report and
the Educational Supervisor will consider WPBA and other evidence such as examinations
passed and experiential outcomes recorded in the portfolio. The competencies will be
considered under 11 domains:
i. Providing a good standard of practice and care
ii. Decisions about access to care
iii. Treatment in emergencies
iv. Maintaining good medical practice
v. Maintaining performance
vi. Teaching and training, appraising and assessing
vii. Relationships with patients
viii. Dealing with problems in professional practice
ix. Working with colleagues
x. Maintaining probity
xi. Ensuring that health problems do not put patients at risk
Underlying Principles of Workplace Based Assessments
Workplace based assessments must comply with the following:
They must focus on performance (i.e. what you actually do in the workplace)
They must be evidence based
Evidence must be triangulated whenever possible (i.e. it must be provided by
different assessors, on different occasions, and if possible using different methods)
Records must be permanent – assessment forms must not be lost or destroyed (this
is achieved by online storage).
Purpose of Workplace Based Assessments
The purpose of the workplace based assessments is twofold:
Firstly, they have a formative function as the basis for feedback and educational
planning. This helps included helping identify any specially focused teaching and
learning that might be necessary to fill gaps or resolve weaknesses. You should have

WPBAS completed regularly throughout your placement to demonstrate effective review
and appraisal. Therefore, do not leave them until the end of each stage of training or
clinical placement.
Secondly, although individually they have no ‘pass’ or ‘fail’ score, taken together WPBAs
contribute to the Annual Review of Competence Progression (ARCP), which has a
summative function providing evidence of the attainment of competencies. Successful
completion of the ARCP process is mandatory for eligibility for the MRCPsych
examinations.
Type of Workplace Based Assessments
There are 8 workplace based assessments currently available. These are described in detail
in the trainee and assessor guidance for each WPBA tool and are merely outlined below.
Assessment of Clinical Expertise (ACE)
The assessor observes a whole new patient encounter in order to be able to assess
your ability to take a full history and mental state examination and arrive at a diagnosis
and management plan.
Mini-Assessed Clinical Encounter (mini-ACE)
The assessor observes part of a patient interaction, for example history taking or
negotiating a treatment plan, and rates your performance.
Case-based Discussion (CbD)
You select two sets of notes of patients you have recently seen and the assessor picks
one to discuss. The discussion will allow demonstration of clinical decision-making and
the application of clinical knowledge.
Case Presentation (CP)
This tool can be used when you give clinical presentations and involves assessment of
domains such as presentation skills and interpretation of evidence.
Journal Club Presentation (JCP)
This can be used when you present a journal article and covers domains such as
analysis and critique and answering questions.
Directly Observed Procedural Skills (DOPS)
This has more limited use in psychiatry compared to other areas of medicine but can
used in situations such as administering ECT.
Mini-Peer Assessment Tool (mini-PAT)
It allows co-workers to assess your attitudes and behaviours and ability to work well with
colleagues.
Assessment of Teaching (AoT)
This is a new tool that has been developed after feedback from the pilot programme. It
allows an assessment to be made of teaching skills and may relate to a lecture, tutorial
or small group teaching session that you lead.
Carrying out Workplace Based Assessments
You are responsible for organising your assessments. You should discuss the areas in
which you need to be assessed with your Educational Supervisor and plan your WPBAs
accordingly. Remember that you will need to be assessed by a range of different assessors
in different situations to ensure triangulation of evidence. Don’t rely on your Educational
Supervisor to perform all the assessments! Also remember that you must ask for the
patient’s agreement when you perform a WPBA that involves a patient.
There is an online system for the completion and storage of WPBAs. You can register for
this through the College website and it can be accessed at http://training.rcpsych.ac.uk/.
After you register you will be able to access the forms relevant to the mandatory WPBAs (ie

ACE, mini-ACE, CbD and mini-PAT). Your assessors must then complete these
assessments online.
Workplace Based Assessment Requirements
The learning needs of individual trainees will determine which competencies they need to be
assessed in and the number of assessments that need to be performed; the College
Assessment Programme’s eligibility structure should be regarded as a minimum number.
Briefly, the number of WPBA’s stipulated in the Assessment Programme for CT1 and ST2&3
is as follows
Minimum Number required per year
WPBA CT1 CT2 / ST2 CT3 / ST3
Ace 2 3 3
Mini-ACE 4 4 4
CbD 2 2 2
mini-PAT* 2 2 2
Recommended Number per year
WPBA CT1 CT2 / ST2 CT3 / ST3
CP 1 1 1
JCP 1 1 1
DOPS
As the opportunity arises
AoT
As the opportunity arises
*There will be 5 rounds of mini-PAT’s per year of which 2 must be completed
The guidelines in the above tables should be regarded as the minimum number of
WPBAs: many trainees will need to do more, for example to provide additional evidence of
achievement in a particular area of professional practice. It is important to again note that
there is no ‘pass’ or ‘fail’ score for WPBA.
You must note that, since they form the basis for feedback and educational planning, you
must arrange WPBAs at appropriate intervals throughout your training rather than leaving
them until the end of each stage. In particular, we strongly suggest that within the early
stages of each phase of training or clinical placement (i.e. within the first month) you
undertake a mini-ACE or ACE and a CbD. This is because these tools reflect closely the
expected day-to-day work of a psychiatric trainee both in terms of the assessment of cases
and clinical reasoning and judgement. The purpose of these early assessments is to identify
what you are doing well and in which areas you need to develop. They contribute valuable
information to the educational planning of your placement. Therefore it is most unlikely that
assessments made early will produce ratings consistent with performance at the standard
expected for the completion of the stage of training.
Educational Supervisors Report / College Tutor’s Report
The Educational Supervisor’s Report and the College Tutor’s Report will be submitted for
consideration by the ARCP. It is the ARCP that validates the achievement of competence
after considering the presented portfolio information. It is important to note that as the ARCP

considers a range of evidence, it is possible for you to have performed well in your WPBAs
but be considered by the ARCP panel to require further development. The outcomes for
ARCP are described in the Gold Guide http://www.mmc.nhs.uk/Docs/A Guide to
Postgraduate Specialty Training in the UK (Gold Guide).doc
Portfolio
This replaces the previous College logbook. It allows you to collate other evidence in
addition to your WPBA. A template can be found here on the Royal College of Psychiatrists
Website:
http://www.rcpsych.ac.uk/docs/Portfolio framework - May 2008 (2).doc
This document is intended to provide a framework from which trainees can build a portfolio
of evidence of their progress and attainment. It should be modified and adapted to suit
individual training needs. Duplicate pages of each section should be created as necessary.
This framework should be used electronically and updated regularly. It can then be printed
out when necessary, for example for the Annual Review of Competence Progression.
Suggested timetable for submission of WPBA’s
This is a suggested timetable for a trainee in a six-month placement; schedules for individual
trainees will vary depending upon local requirements and the trainee’s needs.
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6
SPECIFIC FORMS TO BE SUBMITTED DURING CERTAIN MONTHS
Individual
learning plan
1st self
appraisal
It is
recommended
that one of the
patient
encounter
forms (ACE or
mini-ACE) is
completed now
*Self appraisal
form for 3
months
*Mid term
assessment
form
Mini-Peer
Assessment
Tool
*Self appraisal
form (month
5)
OVER THE 6 MONTH PERIOD
Combination of ACE/Mini ACE/CbD – total of 4 forms to be submitted during 6 month rotation
Case Conference Presentation – at least 1 form to be submitted every 12 months
Journal Club Presentation - at least 1 form to be submitted every 12 months
AoT should be completed as the opportunity arises
DOPS (for the those carrying out ECT) submit until lead clinician is satisfied with progress
*Where these are required by your Trust and/or Programme, also note your local arrangements for
submission of the Educational Supervisor’s Structured Report and workplace based (NHS) appraisal
ARCP Requirements

Trainees are required to complete the following in preparation of their ARCP assessment.
1. WPBAs completed as directed above
2. Educational Supervisor Form – 1 completed for each rotation (e.g. 2 posts in 12
months = 2 reports)
3. College Tutor Form
4. Evidence of Psychotherapy Development
5. Evidence of PCT training
6. Portfolio (completed in accordance with the Royal College of Psychiatrists Portfolio
Guidance inc. results of WPBAs and Exam Certificates) Must include:
i. Evidence of Clinical Activity (logbook)
ii. Educational Plan
iii. Evidence of MRCPsych attendance
iv. Exam Sitting / Results / Certificates
v. NHS Appraisal
vi. Any other evidence
7. Confirmation of completion of PMETB survey
8. Form R
9. Any other evidence that they feel will be beneficial to the ARCP process
All the information must be presented to the trainees’ Educational Supervisor / College Tutor
at the Pre-ARCP meeting. The Educational Supervisors / College Tutor will make a
recommendation of Outcome to the ARCP panel. Failure to produce this information will
result the Educational Supervisors / College Tutor recommending to the panel that an
Unsatisfactory Outcome be issued. The trainee will then be required to meet with the panel
and discuss the missing evidence and agree future action.
Paperwork Required for ARCP
Trainees will be required to submit prior to the ARCP the following documentation:
Educational Supervisors Report (signed copy with original being retained by the trainee)
College Tutor Report (signed copy with original being retained by the trainee)
Trainees who attend a face to face ARCP will also be expected to bring the following with
documentation for review:
Portfolio – completed in accordance with the Royal College of Psychiatrists Portfolio
Guidance inc. results of WPBAs and Exam Certificates
Educational Supervisors Report (original copy)
College Tutor Report (original copy)
Evidence of Psychotherapy Development
Any other evidence they feel will be beneficial
Key Contact Details
Head of School of Psychiatry
Dr Kate Lovett

Training Programme Directors
Child and Adolescent Psychiatry
General and Old Age Psychiatry
Forensic Psychiatry
Dr Sarah Huline-Dickens
Dr Giles Richards
Dr Eluned Dorkins
Clinical Tutors
Cornwall Partnership Trust
Devon Partnership Trust
North Devon Partnership Trust
Plymouth Partnership Trust
South Devon Partnership Trust
Dr David Cox
Dr Charles Dixon
Dr Alison Collins
Dr David Bickerton
Dr San Sreenath
Regional Advisor
Regional Advisor - Peninsula
Dr Mike Metcalfe
Deanery Contacts
School Manager
School Administrator
Heather Rowley
Carla Miners