A seven-year review (2011-17) of the work-based assessment component of Malta’s Specialist Training Programme in Family Medicine

Abstract

Background: Work-based assessment (WBA) within Malta’s Specialist Training Programme in Family Medicine is recorded using the ‘One-to-One Appraisal’ form in the General Practitioner (GP) Trainee Educational ePortfolio. -- Objectives: The postgraduate training coordinators in family medicine review the above annually to see where the WBA is operating well and to identify where improvements are required. -- Method: The ‘One-to-One Appraisal’ involves the completion of a scoring system (selecting one score from ‘needs further development’: 1-2-3; ‘competent’: 4-5-6; and ‘excellent’: 7-8-9) for twelve competency areas. The educational portfolio is reviewed using objective requirements listed in the form ‘Review of the GP Trainee Educational Portfolio’. -- Results: The review of educational portfolios revealed commendable practices including detailed educational plans and case-logs, a general trend of adherence to time frames, and high attendance rates for group-teaching sessions. While One-to-One Appraisal documents were filled in satisfactorily, the issue of remarkably high average scoring was encountered. Moreover disparities were seen between scores and comments in some of the ‘GP trainee interim review by GP trainer’ forms. Deficiencies were outlined in clinical supervision time, mainly during family medicine government placements, while incomplete adherence to placement requirements was noticed. -- Conclusion: A significant amount of quality work was carried out by the GP trainees under their trainers’ supervision. Two main areas of improvement were however outlined – the need for refining the GP trainers’ score allocation and the importance of regular review of the portfolio by both trainees and trainers, with the prompt flagging of persisting unresolved issues to the training coordinators.