10 a month training principle: Assessment is a learning tool (2023)

From children and teenagers

We believe it is important that children, young people and families are involved in RCPCH assessments. We tried new ways of doing this for the MRCPCH and RCPCH START exams (assessment) - thinking about using emojis and asking children and young people to write questions and give feedback.

Throughout 2019, we've been sharing ideas about all parts of the Curriculum, which can help us understand what's important to us in your assessments.

See RCPCH progress - what the domains mean for children and young people

Take out the elephant - video

One of the challenges of being a pediatrician is that you have to be good at many different things.

Parisut Kimkool sat down with Dr. Jonathan Round, Director of the London School of Paediatrics, to discuss how to use notes effectively in this film.

assessments in action

Sometimes seeing proven examples makes it easier to understand how to put things into practice. Hannah Davies, Dr. Daniel Evans, Dr. Patrick Joseph Mullaly, and Dr. Jennifer Williams collected the following cases.

(Video) Progress+ Principle of the Month 10: Assessment is used as a learning tool

Be an opportunist! - case study

Context:Child Assessment Unit (CAU)

Type of evaluation:Mini-CEX (Clinical Evaluation Exercise)

Participants:ST1-3 pediatrics and pediatric consultant

What happened?An 18-month-old boy was referred by his primary care physician for a petechial rash on his face and neck. A pediatric intern attending CAU notices that the consultant is free and asks him to monitor the patient's admission.

After a quick initial assessment, the intern and counselor are confident that the child is not seriously ill and that the assessment can be done safely. Then the intern collects a detailed interview from the mentor. In the medical history, the resident examines all possible warning signs correctly and states that the child had several episodes of vomiting and diarrhea in the last two days, with the appearance of petechiae this morning. The intern examines the patient and summarizes his findings to the consultant. The intern suggests a care plan, but given the good appearance of the baby, he does not know how far to go with the petechiae and whether he should start antibiotic therapy.

When the intern spoke to the mentor, the mentor became very angry. The family doctor mentioned meningitis to them and they were very worried. The intern listened to their concerns and calmly comforted them. The consultant was impressed with the intern's ability to cope with this unexpected turn of events.

How can this scenario help trainees learn?After initiating the management plan, the intern discusses it with the CAU consultant. The consultant confirms that the trainee has independently assessed the patient, made a reasonable differential diagnosis and decided on a reasonable primary diagnosis, planned the appropriate tests and initiated a treatment plan based on the primary diagnosis. The consultant then addresses some knowledge gaps and directs the intern's attention to the latest research on petechiae in children.

The consultant completed two mini-CEXs for the intern - one forArea 4 refers to the treatment of patients, a drugi zaDomain 2 in communication.

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Any practical tips?The most effective way to round out your portfolio without spending a lot of extra time at home is to use daily scenarios for different types of assessments. It is true that we demonstrate many domains every day, but we do not formally evaluate them.to stop. It's time to make the portfolio work for you. As Tom Clancy said, "Every person you meet - and everything you do in life - is an opportunity to learn something!"

Assessment should be adapted to the needs of students - case studies

Context:Resus Bay, Children's Emergency Service

Type of evaluation:CBD Leader (Case Based Discussion)

Participants:Pediatric Emergency Medicine (PEM) ST6 under the supervision of a PEM consultant with a resuscitation team (PEM nurses, pediatric registrar, pediatric SHO)

What happened?The emergency room was initially informed about the imminent arrival of a 6-year-old boy who is seriously ill and has difficulty breathing. The PEM ST6 is requested to perform CPR under the guidance of a PEM consultant. They call the entire pediatric team, they predict a very bad child from the pre-notice. The PEM imager then leads the acute presentation team.

After successful resuscitation and safe transfer to a further care unit, the PEM ST6 and the consultant discuss how to proceed with the case, with particular emphasis on team management skills.

How did it help the training and the participants?This scenario is discussed in detailDomain 6 for leadership and team work, allowing the trainer and participant to shape the discussion and feedback after the event, incorporating different qualities of leadership and teamwork within the scenario. The simulated scenario, in particular, allows the candidate to test these skills, and the thoughtful discussion that follows will allow you to identify where they can improve.

Any practical tips?Educational conversations should be dynamic. Focus areas for assessment discussion can be tailored to support the specific learning needs of participants. Therefore, the same resuscitation may lead to different conclusions for different participants. It is important that the trainee regularly reflects on his skills so that he can help the coach to give feedback on the aspects he wants to develop. In the same way, trainers can identify aspects of learning that the participant may need to develop, but which they themselves have not recognized.

(Video) The first 20 hours -- how to learn anything | Josh Kaufman | TEDxCSU

Rankings can show growth - a case study

context: UTI in newborns

Type of evaluation: DOPS (directly observed procedural skills)

Participants: Pediatrics ST2 under the supervision of a subspecialist for newborns ST7, who in turn is supervised by a neonatology consultant.

What happened?A newborn in the 30th week of gestation was admitted to the neonatal ward and subsequently examined for sepsis. A few days later, the child's condition worsened and intubation was required. Consultant neonatologist, neonatal ST7 and pediatrician ST2 were present. This was used as an opportunity for ST2 to attempt intubation after he had already witnessed several such intubations. ST7 supervised ST2 during intubation while the consultant supervised ST7. After an unsuccessful attempt at ST2, they were intubated at the registrar's office under the supervision of a consultant.

How did it help the training and the participants?Despite failing the trial, ST2 demonstrated several key skills that indicated he was ready for intubation, including proper preparation, deciding on team roles, and ensuring contingency plans were in place. They received feedback from ST7 on how they could improve their technique for future testing. The DOP study on intubation was completed and included in ST2. This DOPS was connected to that oneDomain 3 for clinical procedures.

Any practical tips?It is important that trainees actively seek learning opportunities and, if possible, document them in the form of assessments. In this case, it is also important to note that a failed routine attempt is still useful in the DOP log, since a future successful attempt at the same routine will now clearly show progress.

Furthermore, when several seniors are present, the raters also have many opportunities to learn! In this case, for example, having a consultant witness the work of TS7 and supervise junior colleagues opens up opportunities for formal assessment of TS7.

One event can offer many possibilities for evaluation - a case study

Context:Joint Pediatric Clinic

(Video) How to learn any language in six months | Chris Lonsdale | TEDxLingnanUniversity

Type of evaluation:CBD protection

Participants:Senior intern in pediatrics and pediatric consultant.

What happened?The child visits the pediatric registrar for consultation with the child protection doctor as part of the pediatric community rotation. A supervising consultant was asked to attend the appointment to observe the injury and it was agreed that he would carry out a child protection CBD during this appointment. The result of this examination requires further examination of the child, which will reveal more injuries, and these results need to be discussed with other services, including social services and the police, as well as with the parents. The registrar directs the organization of multidisciplinary teamwork.

How did you support the training and the participants?This scenario applies in particularDomain 9 for protection. Safeguarding cases can involve a significant amount of collaborative work between agencies and parents, so this is an excellent opportunity for a trainee to take a lead role under the supervision of a consultant and complete CBD safeguarding.

Other evaluation possibilities may arise from a single case. Often, litigation requires reports that the intern can prepare in collaboration with the supervisor, which provides an opportunity for a DOC assessment (correspondence hearing). These cases are usually discussed during the departmental peer review, which is an excellent opportunity for the intern to present the case to colleagues and earn a mini-CEX.

Any practical tips?All of this is work that many interns already do, and by standardizing the incorporation of assessment into our daily lives, we can maximize the educational value of typical scenarios and get recognition for the hard work we've already done! This is also an example of a typical situation where there are many opportunities to use assessments to structure and record student development.

What is the evidence? - training presentation

Educational strategies must be evidence-based, similar to clinical strategies. Jong Eun Song prepared the following presentation for local use, which explains the evidence base for using assessments as a learning tool. Download below as a PowerPoint or PDF presentation.

Learn more about what to expect from Progress+

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This month we spoke to intern Dr Parisut Kimkool (ST5, North West London Deanery) and several interns from Wales Deaneries - Dr Hannah Davies (ST5), Dr Daniel Evans (ST2), Dr Assim Javaid (ST6), Dr. dr. . Patrick Joseph Mullally (ST3), Dr. Jong Eun Song (ST2) and Dr.


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