There are different types of assessments throughout the new curriculum ranging from the formal MRCOG examinations to workplace based assessments, such as OSATS. A number of trainers and trainees have requested clarification regarding the requirements in the training portfolio for specific numbers of procedures with workplace based assessments to be satisfactorily performed before a competence can be signed off by a trainer.
Report of the Curriculum Committee -- February 2008
The evidence base for numbers of procedures necessary to confer competence is not particularly robust: a minimum number and regular exposure is thought to be educationally valid. As we collect data during the first iteration of the new curriculum there will be evidence produced to allow the RCOG to adjust the logbook requirements.
At present the curriculum and logbook requirements for numbers are for guidance only
It is obvious that each trainee will develop at a different rate and some trainees will carry out more supervised procedures than others before the trainer is satisfied that competence has been achieved and the trainee can practice independently. In order to provide some structure to the delivery of elements of training and to recognise the relative importance of different procedures within the curriculum, suggested numbers of procedures were included in the logbooks.
Workplace-based assessments
There is considerable experience in the use of OSATS for the assessment of trainees in obstetrics and gynaecology. The numbers required in the curriculum are based on prior knowledge of trainees’ performance and are particularly important at ST2. However, these numbers are also indicative. Where a trainer is satisfied that a trainee is competent then it is entirely appropriate for them to sign off that competence recognising that the number suggested in the curriculum is a guideline and benchmark for the majority.
‘Way points’
There are 2 main ‘way points’ in the curriculum: moving from ST2 to 3 and ST5 to 6. The level of employment at ST3 and ST6 is significantly different for trainees and therefore the assessments required to progress to ST3 and ST6 will be scrutinised in detail. Trainees and trainers will need to provide evidence in support of competences signed off if the minimum number of OSATS has not been achieved.
Summary
Although the emphasis of the logbook is towards competence based on numbers of procedures and assessments satisfactorily completed, the judgment of a trainer about a trainee’s performance is a global judgment.
Global judgments allow trainers to assess competence in the context of professionalism
This judgment is most important in terms of ensuring the curriculum is producing the obstetricians and gynaecologists of the future.