I am going to focus on NHS e portfolio here.
There are quite a few portfolios available for non trainees and it all depends on what your supervisor is willing to support you with.
We have:
1. HORUS portfolio
Mainly used by foundation trainees in the NHS
https://horus.hee.nhs.uk/sign-in
2. NHS e portfolio
Used by medical trainees ( trainee SHOs and registrars )
https://www.nhseportfolios.org/Anon/Login/Login.aspx
3. SARD
Used for non trainee SHOs - trust dependent
4. Fourteenfish
https://www.fourteenfish.com/
Used by GP trainees
There are a few more but I am going to focus on NHS e portfolio as I am familiar with it.
PAYING FOR IT:
In some cases, the trust might pay for your portfolio so ask the study budget team ASAP ( They did it for me back in 2016 but other colleagues working elsewhere had to pay for it from their own pocket)
WHOM TO CONTACT:
You can email them on the email address given here:
https://www.nhseportfolios.org/Support/HelpCentre?manageTextId=22&searchText=#:~:text=If%20you%20have%20an%20NHS,your%20access%20to%20your%20account.
An email along the lines of:
' Hello,
I am one of the non trainee SHOs who has just started in ****. Dr **** who is a consultant in *** has very kindly agreed to become my supervisor from **** to **** ( insert dates of your official work contract). Can you kindly set my NHS e portfolio up please so that I can start working on it?
Many thanks'
In a few days, you should receive a link prompting you to fill out your details and pay for it. As mentioned above, your trust may pay for it hence remember to keep receipt of payment ( should be sent via email) which you can then use to claim for expenses.
Once it has been paid for and set up, you can then start using it.
I am going to discuss one tab in each section
Post/supervisors details - add in your supervisor if it has not been done for you. Sometimes, it can be tricky to add supervisors as the NHS e portfolio does not recognize them as supervisors ( like my supervisor was saved as a registrar on their system hence I had to email the support team to let them know). So if you struggle to update your supervisors details, do not panic. Email the support team and they should be able to sort it out.
Declarations and agreements - 6 years and I have never seen anything here. So I do not know what this is about
Certificates and exams - This is where you upload any certificates of attendance for teaching sessions/ conferences you have attended since the start of this post, any certificates of UK based post graduate exams you have given
Personal library - You can upload relevant documents here.
As a non trainee I did not add much here but in my core medical training ( now replaced by IMT) and current speciality training post (ST5 acute medicine ) , I upload all the relevant documents here as this is what my ARCP panel will look at this ( as you can see, there is an ARCP folder here ). I have also made additional folders relevant to my speciality like specialist skills, etc.
Outstanding tickets - If you have been asked to fill any tickets for others who are using NHS e-portfolio which have been sent to the email your portfolio is registered with, you will get additional notifications here.
My filled forms - all the forms you have filled for yourself when you start using your portfolio more regularly
Download/export- you can downlaod certain parts of your portfolio to print out and highlight during your appraisal, interview, etc.
You will be given a curriculum to follow when you get your portfolio. Usually it is equivalent to IMT1/CMT1/ST1 and varies from year to year and from speciality to speciality.
In training, we have to link assessments related to that particular point in the curriculum.
If you click on all forms, you will get a list of forms.
This is a basic summary:
https://www.jrcptb.org.uk/assessment/workplace-based-assessment
You see 5 different cases ( when clerking) , they are seen by a consultant later on ( like a post take) and you can then send them a ticket for an ACAT
Attendance at organized teaching
If you have attended any teaching session, reflect upon it here.
I have mentioned this in more detail here:
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
Audit
If you have done any audits, QIPs you can summarize them here
Audit assessment
Once you have presented your audit/QIP, you can ask your supervising consultant to fill out an audit assessment form/QIP assessment tool ( QIPAT)
Case based discussions (CBD)
Whenever you discuss a case with a registrar /consultant, you can request them before discussing the case with them if you could send them a CBD. They can then ask general questions and then fill out an assessment form
DOPS ( Directly observed procedural skills )
One simple rule:
Observe
Do under supervision
Keep doing under supervision till you are confident
Then do independently
In the NHS, before you do a procedure like LP, ascetic drain chest drain, central line , you need to be signed off.
These are the list of procedures a SHO is expected to do ( not in their first few days but before they become a registrar so do not worry if you cannot do all of these as a non trainee SHO).
https://omarsguidelines.blogspot.com/2020/02/procedures-sho-is-expected-to-do-in-nhs.html
DOPS are of 2 types:
Formative DOPS
These DOPS are not pass or fail. These are assessments we ask registrars/consultants to fill out when we have done a procedure for the first time. Like when I did a LP in 2016 as a non trainee SHO, my registrar had to guide me to do a lumbar puncture. She had to take over but was happy that if I continue doing it , I will be signed off.
So I did another one - I was better this time and felt more confident. But I needed supervision. I sent the registrar a formative DOPS.
I continued to do LPs- and I could do them independently after a few attempts
Summative DOPS
These DOPS are a pass or fail.
So taking my example above, once I was completely confident, I asked my registrar to observe me and she signed me off when I sent her a summative DOPS.
EDUCATIONAL MEETING
These are meetings with your supervisor
EDUCATIONAL SUPERVISORS REPORT
At the end of your rotation in that trust, prior to your ACRP/ Appraisal, you will sit with your educational supervisor who will go through all of the assessments, ensure you have met your curriculum needs and if there are any concerns.
END OF ATTACHMENT APPRAISAL
If you rotate in different specialties, you will have a clinical supervisor ( CS) for each placement at the end where your CS will go through your portfolio and ensure the objectives you set in your PDP ( personal development plan) have been met.
Please note that if you are working in the same speciality as your ES, your ES will also be your CS for that placement.
INDUCTION APPRAISAL FORM
When you have your first meeting with ES/CS/Both, they will fill out an induction appraisal form which will set your PDP, plans and what they expect you to achieve and what you wish to achieve from this placement.
MINI CEX - mini-clinical evaluation exercise
This supervised learning event (SLE) tool evaluates a clinical encounter with a patient to provide feedback on skills essential for good clinical care such as history taking, examination and clinical reasoning. The trainee receives immediate feedback to aid learning. It can be used at any time and in any setting when there is a trainee and patient interaction and an assessor is available. SLEs may be linked to curriculum items in the ePortfolio.
To summarize, if you examine a patient/ take a history/ discuss the management plan/ discuss DNACPR with a patient/their relatives under supervision of a consultant/registrar, you can then send them a ticket for mini-CEX
As mentioned before, ensure you ask the reg/consultant beforehand
MSF - multisource feedback
This tool is a method of assessing generic skills such as communication, leadership, team working, reliability etc, across the domains of Good Medical Practice. This provides objective systematic collection and feedback of performance data on a trainee, derived from a number of colleagues. "Raters" are individuals with whom the trainee works, and includes doctors, administration staff, and other allied professionals. The trainee will not see the individual responses by raters.
This is filled by everyone from HCAs, nurses, nurse in charge, ACPS, ANPs, FY1s, SHOs, registrars, consultants, ward clerks, therapists and any other healthcare professionals whom you have worked with during your placement.
It is a simple form which asks questions like whether you are punctual, professional, have the basic knowledge and if anyone has any concerns.
MSF - self
We have to rate ourselves as well. I just state that I meet expectations. I am not critical of myself here either as this can be used as evidence against you in court.
Multiple consultant report ( MCR)
MCRs and like MSFs but consultants fill them out.
Personal development plan (PDP)
This is a list of things you wish to achieve from your placement
For respiratory
1. Learn how to insert chest drains
2. Learn management of type 2 respiratory failure
3. NIV/CPAP/NHF and their indications
4. Work on respiratory HDU
5. Get good at ABGs- try to attempt difficult ones with USS guidance where colleagues struggle.
6. Learn common respiratory conditions seen on the acute take
7. Attend respiratory clinics
And then how you wish to achieve them
Via work based assessments ( WBAs)/SLEs, reflections, DOPS, etc
Reflection on a clinical event / management and leadership/after events
I have mentioned this in more detail here:
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
TEACHING OBSERVATION
If you have led teaching sessions, send a consultant a teaching observation assessment form.
TEACHING YOU HAVE DELIVERED
I have mentioned this in more detail here:
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
REFLECTION
PROGRESSION
MCR/MSF
WHO CAN FILL THEM
MCR- Consultants
MSF - any healthcare professional whom you have worked with and whom you know will give good feedback.
There are quite a few portfolios available for non trainees and it all depends on what your supervisor is willing to support you with.
We have:
1. HORUS portfolio
Mainly used by foundation trainees in the NHS
https://horus.hee.nhs.uk/sign-in
2. NHS e portfolio
Used by medical trainees ( trainee SHOs and registrars )
https://www.nhseportfolios.org/Anon/Login/Login.aspx
3. SARD
Used for non trainee SHOs - trust dependent
4. Fourteenfish
https://www.fourteenfish.com/
Used by GP trainees
There are a few more but I am going to focus on NHS e portfolio as I am familiar with it.
What is an e-portfolio?
As explained here:
https://www.healthcareers.nhs.uk/career-planning/developing-your-health-career/developing-your-portfolio/e-portfolios-doctors
It is an electronic way of recording your procedural, communication skills and logging continuous professional development
As explained here:
https://www.healthcareers.nhs.uk/career-planning/developing-your-health-career/developing-your-portfolio/e-portfolios-doctors
It is an electronic way of recording your procedural, communication skills and logging continuous professional development
DIFFERENCE BETWEEN PORTFOLIOS OF TRAINEES AND NON TRAINEES
1. Trainees have to fill out their portfolios on a regular basis. They will be assessed in their ARCPs on the basis of this. They have to meet the requirements mentioned here to get a satisfactory outcome and progress in their training post
This is what they need to achieve:
https://www.jrcptb.org.uk/training-certification/arcp-decision-aids
This is what they need to achieve:
https://www.jrcptb.org.uk/training-certification/arcp-decision-aids
2. Non trainees may be asked to provide evidence during their appraisals which can be 6 to 12 months from their start date and their appraiser would be looking at their portfolios to see if they have been doing CPD, reflecting and assessments to be at par of what is expected from them.
SETTING UP YOUR E-PORTFOLIO
Once your consultant has agreed that will support you with your NHS e portfolio and are willing to become your educational supervisor for the time you are working in the trust, You can then contact the E -portfolio team and set it up.PAYING FOR IT:
In some cases, the trust might pay for your portfolio so ask the study budget team ASAP ( They did it for me back in 2016 but other colleagues working elsewhere had to pay for it from their own pocket)
WHOM TO CONTACT:
You can email them on the email address given here:
https://www.nhseportfolios.org/Support/HelpCentre?manageTextId=22&searchText=#:~:text=If%20you%20have%20an%20NHS,your%20access%20to%20your%20account.
An email along the lines of:
' Hello,
I am one of the non trainee SHOs who has just started in ****. Dr **** who is a consultant in *** has very kindly agreed to become my supervisor from **** to **** ( insert dates of your official work contract). Can you kindly set my NHS e portfolio up please so that I can start working on it?
Many thanks'
In a few days, you should receive a link prompting you to fill out your details and pay for it. As mentioned above, your trust may pay for it hence remember to keep receipt of payment ( should be sent via email) which you can then use to claim for expenses.
Once it has been paid for and set up, you can then start using it.
I am going to discuss one tab in each section
PROFILE
Personal details - update them. Mention your personal email address especially if you plan to rotate.Post/supervisors details - add in your supervisor if it has not been done for you. Sometimes, it can be tricky to add supervisors as the NHS e portfolio does not recognize them as supervisors ( like my supervisor was saved as a registrar on their system hence I had to email the support team to let them know). So if you struggle to update your supervisors details, do not panic. Email the support team and they should be able to sort it out.
Declarations and agreements - 6 years and I have never seen anything here. So I do not know what this is about
Certificates and exams - This is where you upload any certificates of attendance for teaching sessions/ conferences you have attended since the start of this post, any certificates of UK based post graduate exams you have given
Personal library - You can upload relevant documents here.
As a non trainee I did not add much here but in my core medical training ( now replaced by IMT) and current speciality training post (ST5 acute medicine ) , I upload all the relevant documents here as this is what my ARCP panel will look at this ( as you can see, there is an ARCP folder here ). I have also made additional folders relevant to my speciality like specialist skills, etc.
Outstanding tickets - If you have been asked to fill any tickets for others who are using NHS e-portfolio which have been sent to the email your portfolio is registered with, you will get additional notifications here.
My filled forms - all the forms you have filled for yourself when you start using your portfolio more regularly
Download/export- you can downlaod certain parts of your portfolio to print out and highlight during your appraisal, interview, etc.
CURRICULUM
You will be given a curriculum to follow when you get your portfolio. Usually it is equivalent to IMT1/CMT1/ST1 and varies from year to year and from speciality to speciality. In training, we have to link assessments related to that particular point in the curriculum.
ASSESSMENT
You have different assessment forms:If you click on all forms, you will get a list of forms.
This is a basic summary:
https://www.jrcptb.org.uk/assessment/workplace-based-assessment
ACAT
The ACAT is designed to be used for supervised learning events (SLEs) on the acute medical take but may be on a ward round or covering a day's management of admissions and ward work. The ACAT looks at clinical assessment and management, decision making, team working, time management, record keeping and handover for the whole time period and multiple patients. There should be a minimum of 5 cases for an ACAT assessment. SLEs may be linked to curriculum competencies in the ePortfolio as evidence of engagement with, and exploration of, the curriculum. However, it is not appropriate for an SLE to be linked to large numbers of competencies and for this reason the number of links for an ACAT should be limited to eight curriculum items.You see 5 different cases ( when clerking) , they are seen by a consultant later on ( like a post take) and you can then send them a ticket for an ACAT
Attendance at organized teaching
If you have attended any teaching session, reflect upon it here.
I have mentioned this in more detail here:
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
Audit
If you have done any audits, QIPs you can summarize them here
Audit assessment
Once you have presented your audit/QIP, you can ask your supervising consultant to fill out an audit assessment form/QIP assessment tool ( QIPAT)
Case based discussions (CBD)
Whenever you discuss a case with a registrar /consultant, you can request them before discussing the case with them if you could send them a CBD. They can then ask general questions and then fill out an assessment form
DOPS ( Directly observed procedural skills )
One simple rule:
Observe
Do under supervision
Keep doing under supervision till you are confident
Then do independently
In the NHS, before you do a procedure like LP, ascetic drain chest drain, central line , you need to be signed off.
These are the list of procedures a SHO is expected to do ( not in their first few days but before they become a registrar so do not worry if you cannot do all of these as a non trainee SHO).
https://omarsguidelines.blogspot.com/2020/02/procedures-sho-is-expected-to-do-in-nhs.html
DOPS are of 2 types:
Formative DOPS
These DOPS are not pass or fail. These are assessments we ask registrars/consultants to fill out when we have done a procedure for the first time. Like when I did a LP in 2016 as a non trainee SHO, my registrar had to guide me to do a lumbar puncture. She had to take over but was happy that if I continue doing it , I will be signed off.
So I did another one - I was better this time and felt more confident. But I needed supervision. I sent the registrar a formative DOPS.
I continued to do LPs- and I could do them independently after a few attempts
Summative DOPS
These DOPS are a pass or fail.
So taking my example above, once I was completely confident, I asked my registrar to observe me and she signed me off when I sent her a summative DOPS.
EDUCATIONAL MEETING
These are meetings with your supervisor
EDUCATIONAL SUPERVISORS REPORT
At the end of your rotation in that trust, prior to your ACRP/ Appraisal, you will sit with your educational supervisor who will go through all of the assessments, ensure you have met your curriculum needs and if there are any concerns.
END OF ATTACHMENT APPRAISAL
If you rotate in different specialties, you will have a clinical supervisor ( CS) for each placement at the end where your CS will go through your portfolio and ensure the objectives you set in your PDP ( personal development plan) have been met.
Please note that if you are working in the same speciality as your ES, your ES will also be your CS for that placement.
INDUCTION APPRAISAL FORM
When you have your first meeting with ES/CS/Both, they will fill out an induction appraisal form which will set your PDP, plans and what they expect you to achieve and what you wish to achieve from this placement.
MINI CEX - mini-clinical evaluation exercise
This supervised learning event (SLE) tool evaluates a clinical encounter with a patient to provide feedback on skills essential for good clinical care such as history taking, examination and clinical reasoning. The trainee receives immediate feedback to aid learning. It can be used at any time and in any setting when there is a trainee and patient interaction and an assessor is available. SLEs may be linked to curriculum items in the ePortfolio.
To summarize, if you examine a patient/ take a history/ discuss the management plan/ discuss DNACPR with a patient/their relatives under supervision of a consultant/registrar, you can then send them a ticket for mini-CEX
As mentioned before, ensure you ask the reg/consultant beforehand
MSF - multisource feedback
This tool is a method of assessing generic skills such as communication, leadership, team working, reliability etc, across the domains of Good Medical Practice. This provides objective systematic collection and feedback of performance data on a trainee, derived from a number of colleagues. "Raters" are individuals with whom the trainee works, and includes doctors, administration staff, and other allied professionals. The trainee will not see the individual responses by raters.
This is filled by everyone from HCAs, nurses, nurse in charge, ACPS, ANPs, FY1s, SHOs, registrars, consultants, ward clerks, therapists and any other healthcare professionals whom you have worked with during your placement.
It is a simple form which asks questions like whether you are punctual, professional, have the basic knowledge and if anyone has any concerns.
MSF - self
We have to rate ourselves as well. I just state that I meet expectations. I am not critical of myself here either as this can be used as evidence against you in court.
Multiple consultant report ( MCR)
MCRs and like MSFs but consultants fill them out.
Personal development plan (PDP)
This is a list of things you wish to achieve from your placement
For respiratory
1. Learn how to insert chest drains
2. Learn management of type 2 respiratory failure
3. NIV/CPAP/NHF and their indications
4. Work on respiratory HDU
5. Get good at ABGs- try to attempt difficult ones with USS guidance where colleagues struggle.
6. Learn common respiratory conditions seen on the acute take
7. Attend respiratory clinics
And then how you wish to achieve them
Via work based assessments ( WBAs)/SLEs, reflections, DOPS, etc
Reflection on a clinical event / management and leadership/after events
I have mentioned this in more detail here:
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
TEACHING OBSERVATION
If you have led teaching sessions, send a consultant a teaching observation assessment form.
TEACHING YOU HAVE DELIVERED
I have mentioned this in more detail here:
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
REFLECTION
I have mentioned this in more detail here:
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
https://omarsguidelines.blogspot.com/2021/07/reflecting-as-doctor-while-working-in.html
APPRAISAL
APPRAISAL
Educational meeting, end of attachment appraisal, induction appraisal forms explained above
PDP
Explained above
Educational meeting, end of attachment appraisal, induction appraisal forms explained above
PDP
Explained above
PROGRESSION
This has your ES report and MCR forms which I have explained above
PYA
This is not applicable to us. This is the final assessment we get before we complete our CCT before becoming a consultant:
https://www.jrcptb.org.uk/training-certification/penultimate-year-assessment
https://www.jrcptb.org.uk/training-certification/penultimate-year-assessment
E- LEARNING
You can link your account with e-LFH and do some e-learning. I have not been doing this regularly as it is not mandatory.
PAPER BASED PORTFOLIOS
This is the link to paper based portfolios:
https://www.jrcptb.org.uk/document-library?field_category_area_tid=All&field_category_document_type_tid=All&field_category_specialty_tid=50&page=2
https://www.jrcptb.org.uk/document-library?field_category_area_tid=All&field_category_document_type_tid=All&field_category_specialty_tid=50&page=2
Tips:
1. These forms are self explanatory and are just like electronic NHS e portfolio
1. These forms are self explanatory and are just like electronic NHS e portfolio
2. Remember that you can type in certain points so that it is more legible - like the case for CBD, ACAT. Do not fill any part of the assessment others are supposed to fill for you.
3. As soon as someone fills it, scan it, email it and save it on a folder in your work computer as well as your home computer
ASKING FOR ASSESSMENTS
1. You will work with a variety of healthcare professionals - most of them are lovely and will give amazing feedback on your portfolio assessments. Some will not. With time ( and experience) you will learn who these people are.
This post might help:
https://omarsguidelines.blogspot.com/2019/06/how-to-choose-your-referees-staff.html
This post might help:
https://omarsguidelines.blogspot.com/2019/06/how-to-choose-your-referees-staff.html
2. Always ask your consultant/ registrar FIRST before requesting an assessment.
If you have clerked 5 patients from 0900 to 1400 and the consultant is doing a post take ward round, request them if they could fill out an ACAT for the patients you saw, and if they have time, could you send them a CBD if you could discuss one of the cases with them.
They will then know and assess your clerking, ask a few questions. Again, like mentioned above you can judge whether they will give good feedback or horrible feedback.
If you have clerked 5 patients from 0900 to 1400 and the consultant is doing a post take ward round, request them if they could fill out an ACAT for the patients you saw, and if they have time, could you send them a CBD if you could discuss one of the cases with them.
They will then know and assess your clerking, ask a few questions. Again, like mentioned above you can judge whether they will give good feedback or horrible feedback.
3. Be confident and competent enough before sending any assessments.
I would not send a DOPS for a LP I was doing for the very first time and my registrar had to take over. Instead I would send a DOPS when I was more confident- even if it is a formative DOPS.
As a non trainee SHO, I sent my first assessment at least a few months into my job as in the first 3 months, I was figuring out things for myself and slowly gained confidence
4. You may have to remind people earlier. So stay on top of your portfolio and know what is required. Not so much for non trainees but for trainees, the gold guide gives clear requirements:
https://www.jrcptb.org.uk/training-certification/arcp-decision-aids
I would not send a DOPS for a LP I was doing for the very first time and my registrar had to take over. Instead I would send a DOPS when I was more confident- even if it is a formative DOPS.
As a non trainee SHO, I sent my first assessment at least a few months into my job as in the first 3 months, I was figuring out things for myself and slowly gained confidence
4. You may have to remind people earlier. So stay on top of your portfolio and know what is required. Not so much for non trainees but for trainees, the gold guide gives clear requirements:
https://www.jrcptb.org.uk/training-certification/arcp-decision-aids
HOW TO REQUEST COLLEAGUES TO FILL ASSSESSMENTS
MCR/MSF
WHO CAN FILL THEM
MCR- Consultants
MSF - any healthcare professional whom you have worked with and whom you know will give good feedback.
HOW TO REQUEST MSF/MCRs
Ask them if they are happy to fill an assessment
You can go to them personally ( this is better than just emailing them) and ask :
Ask them if they are happy to fill an assessment
You can go to them personally ( this is better than just emailing them) and ask :
'Hello, are you happy to fill a feedback form for me?'
'Thanks for agreeing, may I have your email address please?'
'Thanks for agreeing, may I have your email address please?'
NHS E PORTFOLIO TICKETS
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Click on create ticket
Enter the type of assessment - MCR/MSF
Enter their email
Enter their email
You should be able to see prefilled details. If you cannot see them, fill them out. GMC/NMC number is not mandatory
Write in the comment for assessor section:
Hello Dr/Miss/Mrs/Mr/First name ( whatever their designation is),
Can you kindly fill out a MCR/MSF form for me please?
Many thanks
Write in the comment for assessor section:
Hello Dr/Miss/Mrs/Mr/First name ( whatever their designation is),
Can you kindly fill out a MCR/MSF form for me please?
Many thanks
Dr **** ( role and department - so that they are able to identify who you are )
TIPS FOR MSFs
- As mentioned in this link https://omarsguidelines.blogspot.com/2019/06/how-to-choose-your-referees-staff.html you should choose the appropriate assessors whom know you well and will give good feedback.
- Be aware of certain **** ( insert swear word of choice here) who seem to be good on your face but can give horrible assessments on our portfolio. Every junior doctor ( FY1s to registrars need assessments ) know about them so there is no harm in getting the low down of a department you are about rotate in by colleagues who have just completed their rotation there.
- Usually, people give reasonable assessments ( 6 years and I have not had any issues or feedback which has raised concern)
- As mentioned in this link https://omarsguidelines.blogspot.com/2019/06/how-to-choose-your-referees-staff.html you should choose the appropriate assessors whom know you well and will give good feedback.
- Be aware of certain **** ( insert swear word of choice here) who seem to be good on your face but can give horrible assessments on our portfolio. Every junior doctor ( FY1s to registrars need assessments ) know about them so there is no harm in getting the low down of a department you are about rotate in by colleagues who have just completed their rotation there.
- Usually, people give reasonable assessments ( 6 years and I have not had any issues or feedback which has raised concern)
HOW TO REQUEST ACATS/CBD/DOPS/other assessments
ACATSAsk the consultant/ registrar beforehand. For example, if you have clerked 5 patients from 0900 to 1400 and the consultant has come to AMU to post take these patients, you can ask them:
' Hello Dr ****, I am one of the **** on call today. I have clerked these 5 patients whom you are about to post take. Do you mind if I could send an ACAT for these cases I have seen ?'
They will not have an issue.
You can either go around them on the post take ward round ( which is better as you learn more) and after the post take is done, you can send them a ticket.
' Hello Dr ****, I am one of the **** on call today. I have clerked these 5 patients whom you are about to post take. Do you mind if I could send an ACAT for these cases I have seen ?'
They will not have an issue.
You can either go around them on the post take ward round ( which is better as you learn more) and after the post take is done, you can send them a ticket.
NHS E PORTFOLIO TICKETS FOR ACATS
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Click on create ticket
Enter the type of assessment - ACAT
Enter their email
Enter their email
You should be able to see prefilled details. If you cannot see them, fill them out. GMC/NMC number is not mandatory
Write in the comment for assessor section:
Hello Dr,
Can you kindly fill out an ACAT for the following 5 cases please?
Write in the comment for assessor section:
Hello Dr,
Can you kindly fill out an ACAT for the following 5 cases please?
- Frail lady, admitted with IE of COPD - 16 admissions in past 1 year for same condition. On nebs, steroids, ABx. Noted to have low potassium, on digoxin ( for AF). I added in digoxin levels. I had a detailed discussion with her about escalation and she agreed that NIV is ceiling of care. She understood this information and I put a RESPECT form in her notes. She was due for transfer to respiratory ward.
- to 5. similar SBAR
Many thanks
Dr **** ( role and department - so that they are able to identify who you are )
Tips for ACATS
- You do not need to be physically present with the consultant. For example if you clerked 10 patients on nights, informed the consultant if they could do an ACAT for the patients you have seen and then presented them in the morning handover , you should be able to go home and the consultants usually keep a note of the patients you have clerked and fill out an assessment ( which you should send when you come back to work - do not feel pressured by requesting a ticket as soon as you go home as you must rest and will be exhausted). If you think you will forget the cases , you can scan a copy of the handover sheet and send it to your work email ( DO NOT send it to your personal email) to remind yourself of the cases when you come back to work.
-Like mentioned above, you will get a general vibe from a consultant/registrar about what feedback you might get. Like if you a consultant is unhappy with your case presentation in the morning handover, you might expect him to give negative feedback in your assessments hence you should not send assessments to such people. Having said this, there are very few consultants who do this and usually all junior doctors are fully aware of such people.
Tips for ACATS
- You do not need to be physically present with the consultant. For example if you clerked 10 patients on nights, informed the consultant if they could do an ACAT for the patients you have seen and then presented them in the morning handover , you should be able to go home and the consultants usually keep a note of the patients you have clerked and fill out an assessment ( which you should send when you come back to work - do not feel pressured by requesting a ticket as soon as you go home as you must rest and will be exhausted). If you think you will forget the cases , you can scan a copy of the handover sheet and send it to your work email ( DO NOT send it to your personal email) to remind yourself of the cases when you come back to work.
-Like mentioned above, you will get a general vibe from a consultant/registrar about what feedback you might get. Like if you a consultant is unhappy with your case presentation in the morning handover, you might expect him to give negative feedback in your assessments hence you should not send assessments to such people. Having said this, there are very few consultants who do this and usually all junior doctors are fully aware of such people.
- You do not have to see all 5 patients in one go. You may have seen 2 on one day and 3 on the next - as long as they have been seen by the same consultant, you can send an assessment once they have seen 5 of the patients you have managed.
CBD
Ask the consultant/ registrar beforehand. For example, if you have seen an interesting patient and the consultant has come to AMU to post take these patients/ on the ward to do a ward round, you can ask them:
' Hello Dr ****, I am one of the **** on call today. I have seen this patient. Is it okay if we discuss this and do a CBD ?'
You can then discuss it there and then or they may ask you to come to their office to discuss it.
NHS E PORTFOLIO TICKETS FOR CBDs
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Click on create ticket
Enter the type of assessment - CBD
Enter their email
Enter their email
You should be able to see prefilled details. If you cannot see them, fill them out. GMC/NMC number is not mandatory
Write in the comment for assessor section:
Hello Dr,
Can you kindly fill out an CBD for the following case please?
Write in the comment for assessor section:
Hello Dr,
Can you kindly fill out an CBD for the following case please?
Frail lady, admitted with IE of COPD - 16 admissions in past 1 year for same condition. On nebs, steroids, ABx. Noted to have low potassium, on digoxin ( for AF). I added in digoxin levels. I had a detailed discussion with her about escalation and she agreed that NIV is ceiling of care. She understood this information and I put a RESPECT form in her notes. She was due for transfer to respiratory ward.
We discussed the indications for NIV, whether she met the criteria , how to manage acute exacerbations of COPD and escalation plans.
Many thanks
Dr **** ( role and department - so that they are able to identify who you are ) TIPS FOR CBDs
-You can use a case you sent for ACAT as a CBD as well. You can discuss one of the cases in detail with the consultant and request them to fill a CBD form for one the patients if they could allow you to discuss with them in more detail. You may have to sit with them and discuss the differentials, red flags, management, etc.
-You can use a case you sent for ACAT as a CBD as well. You can discuss one of the cases in detail with the consultant and request them to fill a CBD form for one the patients if they could allow you to discuss with them in more detail. You may have to sit with them and discuss the differentials, red flags, management, etc.
- Ideally, you should have some baseline knowledge about the case you wish to discuss but I would suggest wasting weeks studying a case to get a CBD. If it is completely rare and you do not know much about it, it is worth reading about it.
- Usually CBDs for rare cases turn out to be more than just a CBD... The consultant or registrar may ask you to do a case presentation or a poster presentation for this. So always tyr your best to seek out such opportunities.
- Usually CBDs for rare cases turn out to be more than just a CBD... The consultant or registrar may ask you to do a case presentation or a poster presentation for this. So always tyr your best to seek out such opportunities.
DOPS
Ask the consultant/ registrar beforehand
Ask the consultant/ registrar beforehand
' Hello, this patient needs a lumbar puncture. I have observed a few before and assisted a few times. Is it okay if you could supervise me?'
You can then do a the procedure
If you feel you were confident and you did not need any help, ask if you can send a DOPS. If you really struggled, I would suggest you attempt on another patient at some other point, gain some more experience and then send a DOPS.
Most registrars are happy to do a formative DOPS even if they had to take over but it is always good to ask beforehand and discuss feedback informally first.
This informal face to feedback will give you a general idea of what sort of assessment you will get.
Although it is very unlikely someone will say this but you would not want feedback like ' No knowledge of local anatomy, unable to perform procedure even with assistance' ( This is very unlikely but this to give a general idea that you should not send feedback to colleagues who are not satisfied with your skills )
You can then do a the procedure
If you feel you were confident and you did not need any help, ask if you can send a DOPS. If you really struggled, I would suggest you attempt on another patient at some other point, gain some more experience and then send a DOPS.
Most registrars are happy to do a formative DOPS even if they had to take over but it is always good to ask beforehand and discuss feedback informally first.
This informal face to feedback will give you a general idea of what sort of assessment you will get.
Although it is very unlikely someone will say this but you would not want feedback like ' No knowledge of local anatomy, unable to perform procedure even with assistance' ( This is very unlikely but this to give a general idea that you should not send feedback to colleagues who are not satisfied with your skills )
NHS E PORTFOLIO TICKETS FOR DOPS
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Open your NHS e-portfolio
Click on assessments
Click on Ticket requests
Click on create ticket
Enter the type of assessment - DOPS ( summative or formative)
Enter their email
Enter their email
You should be able to see prefilled details. If you cannot see them, fill them out. GMC/NMC number is not mandatory
Write in the comment for assessor section:
Hello Dr,
Can you kindly fill out an DOPS for the lumbar puncture I performed under your supervision please?
TIPS FOR DOPS
- Like mentioned above you will get a general idea of the feedback so send it only when you feel you will get good feedback. If you have performed well with limited/ no assistance, you should be able to get a formative DOPS signed off. If you did it completely unsupervised, you can get a summative DOPS ( provided you have one or 2 formative DOPS for the same procedure before)
- You can get formative DOPS for procedures done in simulation as well.
Write in the comment for assessor section:
Hello Dr,
Can you kindly fill out an DOPS for the lumbar puncture I performed under your supervision please?
TIPS FOR DOPS
- Like mentioned above you will get a general idea of the feedback so send it only when you feel you will get good feedback. If you have performed well with limited/ no assistance, you should be able to get a formative DOPS signed off. If you did it completely unsupervised, you can get a summative DOPS ( provided you have one or 2 formative DOPS for the same procedure before)
- You can get formative DOPS for procedures done in simulation as well.
- The assessor does not have to be a reg or consultant. It can be a specialist nurse. Like a cardioversion nurse who can sign you off for DCC. An ICU ACP can sign you off for central lines, etc
FILLING ASSESSMENTS
1. The worst thing someone can do is give negative feedback in our portfolios. They do not have the courage to feedback to our face and do it behind a keyboard. I hate such people. Luckily, not many exist.
Please remember, someone might be having a bad day. This does not mean you need to say horrible things about them.
In the past 6 years, I have NEVER given negative feedback to anyone on their portfolio. I have always sat with them and given face to face feedback or escalated their behavior via the appropriate channels.
2. If you do not like anyone, you can either decline to fill in their feedback or just give neutral feedback. Instead you should escalate this through the appropriate channels.
3. As a medical registrar on call, I ask everyone to send assessments for
- Any cases they have seen and discussed with me ( CBD)
- Any procedures they have done under my supervision ( LP, drains, etc)
- MSFs, any other assessment forms.
My handovers are like
Any sick patients?
Anyone I need to prioritize if you are uncomfortable to manage?
CRASH role allocation
Send any TABS/MSFs/CBDs for cases we discuss, DOPS for any procedures you do while I am there
Please remember, someone might be having a bad day. This does not mean you need to say horrible things about them.
In the past 6 years, I have NEVER given negative feedback to anyone on their portfolio. I have always sat with them and given face to face feedback or escalated their behavior via the appropriate channels.
2. If you do not like anyone, you can either decline to fill in their feedback or just give neutral feedback. Instead you should escalate this through the appropriate channels.
3. As a medical registrar on call, I ask everyone to send assessments for
- Any cases they have seen and discussed with me ( CBD)
- Any procedures they have done under my supervision ( LP, drains, etc)
- MSFs, any other assessment forms.
My handovers are like
Any sick patients?
Anyone I need to prioritize if you are uncomfortable to manage?
CRASH role allocation
Send any TABS/MSFs/CBDs for cases we discuss, DOPS for any procedures you do while I am there
4. If someone is really good, write a very personal assessment - individualized to what they have done. Also nominate them for a star award/greatix award/moment of magic or any appreciation system you have in your trust. Do not let their good work and support go unrewarded.
5. Fill out assessments as soon as possible. I try to do them ASAP and luckily, I get enough time at work to do these. Please do not delay them. You will understand when you
So remember, be kind. These assessments stay with us for a long time ( I still have access to all my assessments from when I started and I will be able to view all of them till I become a consultant). It is heart warming to read the nice things people have to say about you.
I hope this blog post helps.
5. Fill out assessments as soon as possible. I try to do them ASAP and luckily, I get enough time at work to do these. Please do not delay them. You will understand when you
So remember, be kind. These assessments stay with us for a long time ( I still have access to all my assessments from when I started and I will be able to view all of them till I become a consultant). It is heart warming to read the nice things people have to say about you.
I hope this blog post helps.
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