Barts and The London School of Anaesthesia >> Assessment
 
Barts and The London School of Anaesthesia logo
 
 
Sub page banner v2 School of Anaesthesia
 
Assessment

GUIDANCE ON THE USE OF APPROPRIATE WORKPLACE BASED ASSESSMENT TOOLS FOR ST YEARS 1 AND 2

Directly Observed Procedural Skills Form (DOPS)

Anaesthetic Clinical Evaluation Exercise Form (Anaes-CEX)

Case Based Discussion Form (CbD)

Multi-Source Feedback Form (MSF)


Download Directly Observed Procedural Skills Form.

DOPS assessment takes the form of the trainee performing a specific practical procedure that is directly observed and scored by a consultant observer in each of the eleven domains, using the standard form.

Performing a DOPS assessment will slow down the procedure but the principal burden is providing an assessor at the time that a skilled trainee will be performing a practical task.

Being a practical specialty there are numerous examples of procedures that require assessment as detailed in each unit of training. The assessment of each procedure should focus on the whole event, not simply, for example, the successful insertion of cannula, the location of epidural space or central venous access such that, in the assessors’ judgment the trainee is competent to perform the individual procedure without direct supervision.

Feedback and discussion at the end of the session is mandatory.


Download Anaesthetic Clinical Evaluation Exercise Form.

The key learning event in anaesthetic training is the supervised operating list, where management plans are formulated, problems are discussed, techniques and procedures taught and behaviours learnt. Therefore an operating list, obstetric emergency or ICU admission is too valuable an opportunity to miss, and so should be fully exploited for occasional use in trainee assessment. The anaes-CEX is intended to evaluate the core skills that trainees employ in many clinical scenarios throughout the curriculum. In practice, this assessment should be undertaken at the trainee’s behest, in a routine operating list undertaken with a consultant or senior trainee (StR years 6 and 7). The assessor will act primarily as an observer and allow the trainee to manage the major part of the list. The assessor will stimulate dialogue – not in an attempt to gauge depth of knowledge – but more to understand thought processes and management decisions made through the course of a procedure or list. The assessor then scores the trainee in each of the seven domains using the standard form. Feedback and discussion at the end of the session is mandatory.


Download Case Based Discussion Form.

Case-based discussion is designed to evaluate trainee clinical practice, decision-making and the interpretation and application of evidence, by reviewing their record of anaesthetic practice. Its primary purpose is to enable a conversation between trainee and assessor about the presentation and anaesthetic management of a patient. It is not intended as a test of knowledge, nor as an oral or clinical examination. It is intended to assess the clinical decision-making process and the way in which the trainee used medical knowledge when managing a single case. Trainers are always evaluating the clinical practice and clinical management skills of their trainees subjectively and this tool is a way of formalising that process

CbD is useful throughout training and especially as a basis for discussion of complications that may have occurred where the trainee was not directly supervised by a consultant. Another example is for discussion of rare events that may not have occurred during the trainee’s attachment such as eclampsia in obstetric anaesthesia, air embolism in neurosurgical or cardiac anaesthesia, total spinal block in regional anaesthesia, epiglottitis in paediatric anaesthesia. Such discussions may also incorporate an assessment of the adequacy of a trainee’s record keeping, although this in not the primary purpose of CbD.

In practical terms, the trainee will arrange a CbD with an assessor (Consultant or Senior trainee) and bring along a selection of three anaesthetic records from cases in which he/she has recently been solely involved. The assessor selects one and then engages the trainee in a discussion around the pre-operative assessment of the patient, the choices and reasons for selection of techniques and the management decisions with to respect pre-, intra- and post-operative management. The assessor then scores the trainee in each of the seven domains described below, using the standard form.

It may be appropriate only to score 3 or 4 domains at a single event, and it should be emphasised that the purpose of the tool is to understand the decision processes and thinking of the trainee. CbD is the trainee’s chance to have somebody pay close attention to an aspect of their clinical thinking and to provide feedback. Feedback and discussion is mandatory.


Download Multi Source Feedback Form.

jg