Assessing academic clinical fellows in general practice: square pegs in round holes?

Abstract

Academic clinical fellows (ACFs) training in general practice (GP) record competency progression in their Royal College of General Practitioners (RCGP) e-portfolio. The General Medical Council (GMC) recommend that current workplace-based assessments (WPBAs) should be used flexibly and formatively. GP ACFs find the e-portfolio inflexible and often only use the learning log and personal development plan to demonstrate academic progress. This pragmatic pilot was undertaken to evaluate the utility of three assessment tools to trainees in the academic setting. ACFs in two deaneries were asked to pilot the use of an academic learning needs analysis (LNA), a new academic supervisor report (ASR) and current WPBAs. The use and value of these tools was assessed using an electronic questionnaire and a focus group of ACFs. Twenty-two GP ACFs responded to the questionnaire and six participated in the focus group. Use of WBPA was 32% (n = 7), LNA was 55% (n = 12) and ASR was 82% (n = 18). GP ACFs valued discussions of academic progress, particularly the formal identification of areas for development. Use of the tools appeared to facilitate constructive feedback about an ACF's academic role. ACFs disliked tools containing elements that were not applicable to their needs and/or setting, undertaking mandatory academic assessments prior to commencement of their academic post and uncertainty about which WPBA to use. ACFs appreciate formally addressing progress, learning needs and how to maximise the use of their posts. Formative academic feedback would be best accepted if delivered using specifically designed academic tools that are integrated into the e-portfolio. When designing academic tools, both research and education activities need to be considered. Academic experience is a pre-requisite for formal assessment of academic progress; commencing academic activity in ST1 would enhance demonstration of progress in later years.