A typical encounter might be when presenting newly referred patients in the out-patient department. The CbD should focus on a written record (such as written case notes, out-patient letter, discharge summary). It also serves as a method to document conversations about, and presentations of, cases by trainees. The CbD is a tool for supervised learning events (SLEs) based on a trainee's management of a patient and provides feedback on clinical reasoning, decision-making and application of medical knowledge in relation to patient care. If possible the trainee should be assessed on the same audit by more than one assessor. The Audit Assessment can be based on review of audit documentation or on a presentation of the audit at a meeting. The Audit Assessment tool is designed to assess a trainee's competence in completing an audit.
It is unlikely that a single ACAT could provide sufficient evidence but the assessment of overall progress by the educational supervisor will also take into account the multiple consultant reports as part an holistic assessment of the trainees capabilities. The trainee should discuss with their educational supervisor the number of ACAT 2020 supervised learning events required to demonstrate capability. The trainee should have seen at least five patients to make the assessment valid.
If any aspect of the assessment cannot be covered then it is important that the assessor states that they are unable to comment. The ACAT 2020 includes feedback on elements that are critical to running the acute take which will help the educational supervisor in making a judgement on the level of supervision required for CiP 1. Descriptors relating to CiP 1 are included in the ACAT 2020 to prompt the assessor about the elements that they should review and comment on. The internal medicine stage 1 curriculum has a critical decision point at the end of year 2 (IMY2) that determines whether the trainee has the necessary capability to lead the acute take with indirect supervision. Acute Care Assessment Tool (ACAT) 2020 - IMT ACATs may be linked to a maximum of eight curriculum competencies in the ePortfolio. There should be a minimum of five cases for an ACAT assessment. The ACAT looks at clinical assessment and management, decision making, team working, time management, record keeping and handover for the whole time period and multiple patients. The ACAT is designed to be used for supervised learning events (SLEs) on the acute medical take but may be on a ward round or covering a day's management of admissions and ward work. Printable versions of some of the forms can be found in this website's document library by using the search function. These assessment tools are available online in the ePortfolio. Please refer to the relevant curriculum for details. These methods will be used in different ways by different specialties and not all specialties will use all methods. The various workplace based assessment methods are described below.