Getting the E-Portfolio
Firstly, you need to set this up. By the start of ST1 you should have completed Form R (see the guide to completing it, in same email of information and forms from HEE). Once you have given in your form R (along with a photo, the conditions pro-forma and the Transfer of Information form) the Deanery can register you and get a National Training Number (NTN).
Once you have your NTN, go to RCGP website: http://www.rcgp.org.uk/membership/membership-grades/join-rcgp-trainee-gps.aspx.
Here you can register as an Associate in Training, and will be given access to the ePortfolio.
Costs: Total for the 3 years £925.00
Cost is split into 4 installments: initial £273.40 on registering, then £217.20 each April for 3 years.
First few weeks on the E-Portfolio
The best advice is to play around with it, click on links and see where they go – there is quite a lot of different aspects to it and it’s helpful to get familiar.
Check in the ‘Posts’ box on dashboard, or under the Posts area (left hand side menu). Check that they are the posts you are expecting!
You should have an Educational Supervisor, who will be listed as the same for each post
You should also have a Clinical Supervisor, which will be different for each post. If you don’t have anyone listed you need to contact your department and ask them who your clinical supervisor is, then email Programme Directors/Manager so they can add it to your portfolio. In GP it will be your GP supervisor.
You should email both your Educational and Clinical Supervisors early on, to check they are definitely your supervisors and to arrange meetings. There is no specific criteria to have a meeting record (as there is in Foundation), but there is a type of Learning Log called ‘Placement Planning Meeting’, which could be used as a template. This should help you agree on what you want to get out of your placement and how it relates to the curriculum. It is also a good way to discuss your Professional Development Plans (see below), as well as to get to know your supervisors.
You need a ‘Review Period’ for your placement to be set up by your Educational Supervisor. Go to ‘Review Preparation’ in left hand side menu. If there is nothing there you need to ask them to create this review period, else you can’t do log entries etc.
Check in this section that you have signed the appropriate declarations (including Probity, Health and Educational Agreement).
Make sure you regularly check the ‘Educator’s Notes’, ‘Notifications’ and ‘Messages’ sections. Your Educational Supervisor may well contact you through the ‘Educator’s Notes’ section with help and advice on your portfolio (or often to remind you to be doing regular logs..!) so you don’t want to miss these.
PDPs = Personal Development Plans
These should be short, specific targets, rather than a big long list of all the curriculum items within your speciality. i.e. think SMART objectives:
It is helpful to write a few at the start of your rotation and tick them off as you go, and add them as you need. Discuss it with your Educational Supervisor for more guidance.
If you write a log relevant to a PDP, then go to edit your PDP and record the title and date of your log in the ‘Outcome’ section. You can then use this to write about the evidence you have to show you have achieved the PDP.
Go to the ‘Evidence’ section (left hand side menu).
Once your review period is set up the front page will be a summary of what you need during that 6 months, as a minimum: ie.: in ST1/2
3 x mini-CEX (or COT, Consultation Observation Tool, in GP)
3 x CbD (Case Based Discussion)
1 x Clinical Supervisor Report (end of rotation)
CEPS = Clinical Examination and Procedural Skills – ‘as appropriate’ – This is important to cover the examinations including female and male genital examination, and breast examination (new and most of us haven’t got to grips with these yet – see portfolio for guidance)
PSQ (Patient Satisfaction Questionnaire) – need 40 in GP attachment
Reflecting and Learning Logs
Reflecting in learning logs is a skill that you will develop over time. The sooner you start the better, and your Educational Supervisor will give you help and advice. Below are a few useful things to know about the practicalities of reflections and recording them in the e-portfolio.
Types of learning log
Go to Learning Logs on the left hand menu. Firstly, start by looking through the different types of Log entries there are and what they include. The most common to use are:
- Clinical Encounter
- Tutorial or e-learning (doing e-GP e-learning via portfolio (click on ‘Resources’) will automatically create a log, which you can then fill in).
- Professional Conversation
There are other specifically useful types:
- Out of Hours Session, which you must use to log your OOH work
- Significant Event Analysis
- it was a requirement of our ARCP to have at least one every 6 months so do document using this log if you complete a Datix/attend a Morbidity and Mortality meeting/attend a GP Significant Events and complaints meeting, etc.
Clinical Examination and Procedural Skills
These are new and most trainees and supervisors don’t have much experience, so I include the official Portfolio guidance:
“Include entries to demonstrate your ability to perform Clinical Examination and Procedural Skills against the curriculum areas.
Suitable examinations will include cardiovascular, respiratory, neurological, abdominal, musculoskeletal and mental state examinations.
Cases should also include examinations of different patient groups, i.e. elderly and paediatric patients.
Ensure you have linked the entry to the relevant curriculum area.
It is essential within your learning log to include evidence of competence in breast examination and in the full range of male and female genital examinations as there is concern that these may otherwise not be done. Your Educational Supervisor can complete a Clinical Examination and Procedural Skills evidence form if they/you feel this is necessary.
When completing the log entry you need to consider any communication, ethical or cultural issues, for example the use of chaperones or when it was felt to be inappropriate to examine and why.
When appropriate your ES will then be able to validate this entry against the competency for Clinical Examination and Procedural Skills. They may make a comment in the usual way which highlights any areas of concern, or areas of particular strengths etcetera”
There is no official guidance on the number of reflections required per week. Roughly it is expected you will do 2-3 per week, which may include (for example) a quick/shorter clinical encounter, a more detailed/complex clinical encounter and a tutorial.
Generally, reflections should be bottom heavy, i.e. focus most on what you learned and what you will do differently (reflecting!) not simply recounting events. The best way to learn how to do reflections is by trying it out and getting feedback on them, so do check for comments and your Educational Supervisor will give you hints and tips as you go.
Targeting reflections – what to reflect on
Checking out the curriculum and competence areas will give you ideas on what you can reflect on and how every day experiences and situations are useful in your reflection and learning. Try to get a good coverage of curriculum and competence areas, as well as looking at your PDPs to check you are on track to achieving them. You can link curriculum items to your log entries but it is your Educational Supervisor who links the competence areas. Therefore signpost competence areas for your Educational Supervisor.
Where to find Information on Curriculum and Competence Areas
Curriculum: This has the familiar set up of areas e.g. Cardiovascular Health, Women’s Health etc. It also includes a few less obvious areas e.g. The GP Consultation in Practice, The GP in the Wider Professional Environment. In your e-portfolio go to the top right link ‘Resources’ then go to ‘Curriculum’ then ‘Curriculum Statement Headings’.
AKT curriculum: Gives more of a list of presenting symptoms and conditions for each area. Go to: http://www.rcgp.org.uk/training-exams/mrcgp-exams-overview/~/media/D96EB4E0188E4355BCC9221B55859B08.ashx
Competence Areas: Go to ‘Resources’ then ‘Curriculum’ then ‘Professional Competence Areas. There are 13, all listed. If you click on each it will give you a table listing the attributes for a trainee who ‘Needs Further Development’ (ie all ST1s in almost every area!), ‘Competent’ and ‘Excellent’. This is helpful to target reflections and help you show how you meet these competencies in your logs. I found it helpful to print these out and have them easily accessible when writing logs.
Checking on your coverage:
You can check how many logs you have for each curriculum and competence area under ‘Review Preparation’ (left hand side menu). You can then click on the tabs to see your coverage.
It is important to look at this regularly so you can focus on weaker areas. There is no specific guidance on how many logs you need in each area.
Educational Supervisor Input on Logs
Your Educational Supervisor will be the person reading your reflections, not your Clinical Supervisor (although some Clinical Supervisors in GP placements do keep an eye and read them too!). They will read, link Competence Areas and add a comment for each log.
When you initially create a log you can save and go back to edit. Your Educational Supervisor won’t be able to read it until you click ‘Share Log’. This is helpful as you could jot a few notes down in a log then go back, fill it out more fully and then share once you’re happy. Just beware of having lots of half completed and unshared logs, as your Educational Supervisor won’t be able to see that you are doing any work on your Portfolio! Also, try to do logs regularly rather than in clusters to show you are working consistently (and out of courtesy to avoid your Supervisor suddenly having 10 to read and comment on!).
The ST1 teaching is from 2pm – 5pm on the 1st and 3rd Tuesday of each month. Usually it consists of the first hour being an update and ST1 presentation, then the next 2 hours being teaching from a GP/Consultant/Specialist on a useful topic.
Remember to reflect on teaching sessions. It might help to take your laptop with you and makes notes as you go.
A few ideas and by no means an exhaustive list of the opportunities out there:
- CCG meetings during GP rotation – helpful for community orientation, primary care organisation – ask your GP supervisor or Practice Manager
- Skin club – Dermatology meeting at the Churchill Hospital the 1st Tuesday of the month 7pm (but please check to confirm!)
- Local Medical Council – GP partners on panel, GP in Wider Prof environ
- Balint groups – some GP practices have these to share and reflect together.
A few ideas, by no means compulsory but ask around and see what interests you:
- GP Update http://www.gp-update.co.uk/ – many trainees attend, very highly recommended and gives excellent clinical reference handbook.
- RCGP MSK course http://www.rcgp.org.uk/professional-development.aspx
- BMJ masterclasses
- Essential Knowledge Updates
- Online courses e.g. drugs and alcohol
- Minor surgery course (general consensus is it is useful to do it whilst in GP rotation so you can practice skills acquired) http://www.rcgp.org.uk/professional-development/minor-surgery-courses.aspx
- Annual Thames Valley symposium – Spring
- GP careers event in Oxford – Autumn
- RCGP Annual Conference
- RCGP Global Health Conference
Go to ‘Resources’ (top right of portfolio) then ‘MRCGP’, which takes you to the RCGP website and gives information on the exams. Basically there are 2:
AKT = Applied Knowledge Test – a computer-based exam which can be taken in ST2 or 3
CSA = Clinical Skills Assessment – 13 clinical stations, each 10 mins, taken in ST3.
So you won’t be doing any exams during ST1!
Diplomas – some people do them but generally it is encouraged to concentrate on your GP training
DRCOG (Diploma of Roya College of Obstetricians and Gynaecologists– https://www.rcog.org.uk/en/careers-training/drcog/
Diploma in Family Planning – involves some e-learning, an online exam, a 1 day course and then 5 clinic sessions. See Diplomate Assessment of the Faculty of Sexual and Reproductive Healthcare – http://www.fsrh.org/pages/Diploma_of_the_FSRH.asp