Assessments

ASSESSMENTS (RITAs) IN CLINICAL GENETICS

Assessment is an external and objective measure of a trainee’s professional progress. This is formally done through the record of in-training assessment (RITA) process, usually on an annual basis but can be more frequent if a trainee has problems (for example if a RITA D has been given). The RITA interview is based on the outcome of ongoing intra-departmental assessments. It is important that assessment is robust and concentrates only on the professional competence of the trainee.

Organisation – It is recommended that the assessment process in Clinical Genetics be done at a supraregional level, several genetic Centres joining together and establishing supraregional training committees. This is already happening in the majority of the UK.

The organisation of individual assessment panels will need to be agreed by each training committee. A model that seems to be working well in the South West of Britain is the following:

à One of the RSAs chairs the Training Committee for a five-year period. During their time they have administrative support from their local Deanery to organise the annual assessments. The assessment committee consists of at least two external RSAs and a Postgraduate Dean’s representative. The trainees RSA can be invited to join the discussion to clarify points of information etc.

à For penultimate year assessments, a specialist advisory committee representative must be present to complete the necessary form for the SAC. This should be organised by contacting the PYA administrator at the Royal College of Physicians several months in advance so that they can identify an SAC representative.

à When and to whom the various documents are to be sent needs to be agreed by each training committee.

Documents to be provided for the annual assessment (RITA) panel

à Consultant supervisor’s summary along with:

- general assessment form (appendix 2A)

- counselling assessment form (2B)

- administrative/secretarial report (2C)

- appraisal forms for period of assessment

à Two case reports

à Training record, including record of specialist skills acquired and
training needs met (appendix 3)

à Audit report if project completed that year

à Updated Curriculum Vitae

Methods of assessment

à Previous practice - For the majority of assessments, the educational supervisor provided a written report for the assessment committee. With no guidelines for preparing these reports, their quality is variable and content patchy. Helen Kingston in Manchester developed more structured methods of assessment and these acted as a template for most of the forms now to be used.

à The uniform assessment approach.

(1)

The educational supervisor’s report - The responsibility for coordinating the SpR’s assessment reports lies with the educational supervisor. They will write a summary report (standard forms are provided in the trainee’s manual). It should provide a brief synopsis of the year’s training, highlighting particular achievements and if any problems have been experienced. If there are any training needs that need to be focussed on in the following year they should be summarised. Prior to the report being submitted to the RITA panel, the contents should be shared (along with copies of assessment forms) with the trainee and fully discussed. The practice in some Deaneries is that the trainee should co-sign the supervisor’s report and if there are any points of disagreement the trainee particularly wants to highlight, they have the chance to make their own comments.

In writing the report, the consultant supervisor will base the content of the report on the following:

General assessment form (appendix 2A) – This will usually be completed by the educational supervisor or the consultant with whom the trainee has been doing the most clinical work, if other than the educational supervisor. The supervisor may choose to review a series of case notes of families the SpR has seen and review them with regard to diagnosis, whether appropriate investigations were performed, and the standard of the clinic letters, to assist in completion of the form.

Assessment of counselling skills (appendix 2B) – The SpRs counselling should be assessed at least once each year. The suggested format and form to be used is given in appendix 1B.

Administrative/Management skills (appendix 2C) – At any stage of training, it is essential that an SpR will be able to liaise with administrative/secretarial staff and therefore each year a relevant member of the administrative team will be asked to fill in the form shown in appendix 2C.

The supervisor’s written report will be submitted to the RITA panel with the three completed forms.

(2)

Specific genetic skills forms - In addition to general clinical skills, there are some very specific to clinical genetics. In appendix 3 there is a form summarising these and suggesting which skills need to be acquired by which year of training. As each skill is acquired these should be ticked off by the education supervisor. The form should be submitted annually to the RITA panel. In addition the form records attendance at speciality specific training courses and the case report topics.

(3)

Targets for additional activities - It is recommended that the trainees continue to use section seven of their grey folders to record these activities. Suggested targets are:

(A) For presentations – By the end of year 2 the trainee should have presented at hospital Grand Rounds, inter-regional genetics meetings and dysmorphology club. By the end of the third year the trainee should have presented at national and/or international meetings.

(B) Publications – It would normally be expected that on completion of training, clinical genetic trainees will have published work in the field.

(4)

Case reports – Each SpR will produce two case reports per year. The case reports will be 2,000 to 3,000 words and include about ten references. The RITA panel will assess the reports. Guidance on writing case reports is given in appendix 4.

(5)

Audit – There should be clear evidence of active involvement in audit each year. During their training an SpR should take the lead on one audit topic and present either a publication arising from this or a 1500 word summary to the assessment panel in the relevant year.