A.1.3 Overall assessment structure relating to both core and higher EM training

A.1.3 Overall assessment structure relating to both core and higher EM training

The assessment regimen described below is new and will be closely monitored by CEM. The ARCP panels, when using the information gathered from these assessments, will need to take into account the feedback from trainers if difficulty in delivery of these assessments is encountered.

1. 
   Major and acute presentations that must be assessed summatively using either the EM Mini-CEX or CbD successful/unsuccessful tool
   

2. 
   Major and acute presentations that must be assessed (formatively) using either
   

Or Mini-CEX/CbD.

3. 
   The remaining acute presentations that may be covered by the trainee using:
   

Reflective diary entries in the e-portfolio (with clear learning outcomes)

Audit and teaching assessments that relate to acute presentations

Or additional ACAT-EMs

4. 
   Practical procedures, which are assessed in EM using the DOPs EM tool. These are not summative assessments although descriptors of expected performance are provided in the e-portfolio and CEM web site.
   

5. 
   The 25 Common competencies, each of which is described by levels 1-4.
   

Trainees by the end of HST should have reached level 4 in all areas.

Many of these competences are an integral part of clinical practice and as such will be assessed concurrently with the clinical presentations and procedures assessments.

Trainees should use these assessments to provide evidence that they have achieved the appropriate level.

For a small number of common competences alternative evidence should be used e.g. assessments of audit and teaching, completion of courses, management portfolio, which can be used to record management & leadership competencies.

A.1.4 ACCS CT1&2 assessments

The ACCS curriculum has been re-written to more closely integrate the specialties. The AM/EM and part of the ICM content is now presented as 6 major presentations and 38 acute presentations. These should be covered over the typical 18/12 period allocated for AM/EM and ICM.

Two of the six major presentations, which will be covered summatively using Mini-CEX or CbD.

The trainee should be summatively assessed using Mini-CEX or CbD for the following 5 acute presentations:

1 Chest pain,

2 Abdominal pain

3 Breathlessness

4 Mental health

5 Head injury
Another 5 APs should be covered non-summatively using x1 ACAT-EM (or individual Mini-CEX or CbD if the opportunity arises).
Guidance for the completion of an ACAT-EM, are contained within this appendix. A single ACAT can cover up to 5 APs.
It is intended that when the trainee is working in Acute Medicine, they will similarly cover 2 MPs and 10 or more acute presentations using Mini-CEX/CbD or ACAT.
During CT1 AM and EM, trainees should be aiming to sample the remaining 18 acute presentations (10 completed in EM, 10 in AM out of total 38).
The CEM would recommend that 9 should be covered whilst in EM by successful completion of

E-learning modules,

Teaching and audit assessments,

Reflective entries that had a recorded learning outcome into the e-portfolio

Or additional ACAT-EMs.
Trainees at the end of their EM training should seek a summary description of the number and location of patients they have seen e.g. total number seen, number aged <16, number seen in resuscitation area, major side, Paeds and injuries. This can be either in a hard copy patient log or electronic version. This patient log will be required for the Structured Training Report.
Practical procedures -PP

EM has agreed to undertake a minimum of 5 assessments for practical procedures whilst the trainee is in EM in the first 2 years of training. These practical procedures are

1 Airway maintenance

2 Primary survey

3 Wound care

4 Fracture/ joint manipulation

5 Plus one other practical procedure from the list
These assessments will be done using the EM DOPs tool but CEM has written detailed descriptors of expected trainee performance to assist in assessment and feedback. Whilst these DOPs are not summative assessments the assessor should indicate whether or not the DOP should be repeated.
If the opportunity arises additional practical procedures may be completed in EM using the generic DOPs tool provided and available on the trainees’ e-portfolio.
Common Competences - CC

Trainees should seek evidence of level 2 competence for >50% of the common competences in these first 2 years.