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North East Scotland Deanery Portfolio and Progressive Training Record   competency based

General Practice Stream

The 12 Point SHO Rating Scale
Incorporates GMC’s Good Medical Practice

Good Clinical Care

1a

History taking and examination

1

2

3

4

5

6

7

8

9

Incomplete, inaccurate, confusing history taking. Cannot get patient co-operation for examination, technique poor.

Clear history taking, appreciates the importance of clinical, psychological and social factors. Performs adequate and appropriate examinations.

Accomplished and concise history taker; including clinical, psychological and social factors. Skilled examination technique

Effective listener.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

1b

Investigations

1

2

3

4

5

6

7

8

9

Inappropriate, random, unnecessary investigations, no thought given. Often fails to perform investigations requested.

Investigates appropriately, ensures all investigations requested by the team are completed, knows what to do with abnormal results.

Arranges, completes and acts on investigations intelligently, economically and diligently.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

1c

Problem solving / making a diagnosis / management plans

1

2

3

4

5

6

7

8

9

Unable to make decisions, or even make a working diagnosis. Fails to involve patients in decision making.

Can make a sound diagnosis, and produce safe, appropriate management plans. Involves patients in decision making.

Plus - shows intelligent interpretation of available data to form an effective hypothesis, understands the importance of probability in diagnosis.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

Constructive comments are encouraged for all SHOs, for borderline or failing SHOs (scoring 3 or less) much more information is needed. Continue on notes pages if required.

Notes

 

1d

Record keeping

1

2

3

4

5

6

7

8

9

Poor, confusing records. Inadequate, illegible.

Clear records made in notes, medico-legally sound, others are able to understand.

Records his/her information accurately and efficiently. Easy for others to follow.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

 

1e

Emergency Care

1

2

3

4

5

6

7

8

9

Does not respond to emergency calls, chaos and panic in emergency situations.  Inability to do CPR and basic life support.

Responds quickly to emergency calls, works well within team, appropriate management of situation. Proficient in CPR and basic life support.

Shows ability in evaluating the emergency situation calmly and intelligently, establishes priorities correctly, organises assistance and treatment promptly.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

 

1f

Working within limits of competence

1

2

3

4

5

6

7

8

9

No self-confidence, seeks help all the time, does not make any decisions. Over-confidence in ability, with no insight to a level that may harm patients. Unaware of own limits

Aware of own skill and competency level, seeks assistance appropriately.

An able doctor with a clear understanding of own competency, but still seeks advice when appropriate.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

Constructive comments are encouraged for all SHOs, for borderline or failing SHOs (scoring 3 or less) much more information is needed. Continue on notes pages opposite if required.

Notes

 

 

2

Maintaining Good Medical Practice - Commitment to education

1

2

3

4

5

6

7

8

9

Does not see the need for learning, fails to keep up to date, does not learn from mistakes. No involvement in audit. Fixed blinkered approach. Poor attendance at teaching sessions. No use of IT.

Positive approach to learning, keeps up to date, participated in teaching, learns from mistakes. Involved in audit. >50% attendance at teaching sessions. Awareness of and can access electronic learning resources.

Enthusiastic approach to learning, Knowledgeable, reports own errors unhesitatingly and shows ability to learn from the experience. Actively involved in audit. Good (>75%) attendance at teaching sessions.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

3

Relationship with patients

1

2

3

4

5

6

7

8

9

Discourteous, inconsiderate of patients views, dignity & privacy. Unable to reassure, subject of repeated complaints. Discriminates against patients with disability.

Courteous, polite, communicates well with patients, shows appropriate level of emotional involvement in the patient and family. Respects privacy & dignity.

Excellent bedside manner, able to anticipate patient’s emotional and physical needs and plans to meet them.  Explains clearly and checks understanding.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

4

Working with colleagues – Team-working

1

2

3

4

5

6

7

8

9

Unable / refuses to communicate with colleagues. Can’t work to common goal, selfish, inflexible.

Listens to colleagues– accepts the views of others. Flexible– ability to change in the face of valid argument.

Able to bring together views for a common goal. Team goal is put before personal agenda.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

Constructive comments are encouraged for all SHOs, for borderline or failing SHOs (scoring 3 or less) much more information is needed. Continue on notes pages opposite if required.

Notes

 

 

5

Teaching and Training – Developing teaching skills

1

2

3

4

5

6

7

8

9

No interest in teaching, mentoring and/or supervision of more junior doctors and medical students. Few teaching skills.

Beginning to develop teaching skills, supervising more junior doctors and medical students.

Actively involved in teaching, enthusiastic, able to motivate. Clear demonstration of teaching skills.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                       

 

6

Probity: Has a responsible and professional attitude and approach to their work, in the following areas: -

          Trustworthy

          Honesty

          Confidentiality

           Ethics

          Dress code

          Manners

          Punctuality

          Time management

1

2

3

4

5

6

7

8

9

Poor attitude / approach in above areas, possible concerns……

Fails to make care of patient first concern, own beliefs prejudice care, abuses position as a doctor.

Reasonable attitude / approach in above areas, a good doctor.

Excellent attitude / approach in above areas, a credit to the profession.  Patient care is the priority.

 

Score

Evidence

Mid-point Review

 

 

 

Final Review

 

 

 

                           

 

7

Health and Performance

Are there any health issues that are affecting or may affect the junior Doctors fitness to practice?

The Educational Supervisor should try to refrain from adopting the role of the doctors General Practitioner.

Assessment

None

Concerns

Mid-point Review

 

 

 

Final Review

 

 

 

       

 

Constructive comments are encouraged for all SHOs, for borderline or failing SHOs (scoring 3 or less) much more information is needed. Continue on notes pages opposite if required.

Notes

This log book has been derived from the Vocational Training Record for General Practice, produced by the North West Deanery and a series of General Professional Training Curricula produced by the NHS Education for Scotland, GP Unit. Feedback and comments are most welcome. (e-mail: Julian@page00.freeserve.co.uk)

We would like to thank Dr. John Toby, Chairman JCPTGP, Dr. Justin Allen, Secretary JCPTGP and Dr. Stephen Field, Postgraduate Dean, West Midlands for their assistance.

Dr. Julian Page & Dr. Malcolm Valentine

 

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