How to prepare for ARCP - Core Trainees

UPDATE 23/03/20

At the time of writing, we are affected by the COVID 19 pandemic.
Clinical work is disrupted and many training activities are postponed.  Exams have been postponed until autumn and the future ST3 recruitment round is unresolved.
There will still be an ARCP round, and at the time of writing we plan to do this in absentia, based on portfolio evidence.
We are aware that while clinical work and rotations are disrupted some of you will be missing some of your units of training.  We will work with HEE guidance on how to resolve this.
Please make sure you fill in a disruption to training form and upload it to your portfolio.
Further updates will be emailed.
If you have any questions please get in touch.

Janet Slee
Core TPD HEENW Mersey


This is information on how to prepare for ARCP this year. ARCP is the Annual Review of Competence Progression, and a satisfactory ARCP outcome is the formal means by which you document that you have done a year’s training in Anaesthesia at this level.

The ARCP process is now also the means by which you formally accumulate the evidence you will need for re-validation.  We all need to do this to continue to practice medicine – so this is an important message. 

Here is a link to the national RCoA ARCP checklist which I have already sent you:
https://www.rcoa.ac.uk/sites/default/files/documents/2020-02/RCoA%20National%20ARCP%20Checklist%20ES%20guide%20V5.pdf

The notes below will provide more detailed guidance

The ARCP process is a documentary process.  It is your documents visible on your eportfolio (the Lifelong Learning platform or LLLP) that are assessed.

This will be done at an ‘ARCP Panel A’ at Regatta place (Post Code L3 4BL). You will be invited to attend and are strongly encouraged to do so – but the meeting is not part of the assessment. It is an opportunity to be informed of your recommended ARCP outcome, to give and receive feedback, to discuss any issues relating to your training, and to seek advice. The decision on outcome will be decided before that based on the documentary evidence as already stated.

Please make sure your evidence is present and complete 3 days before the Panel A to allow it to be reviewed.

If the documentation is satisfactory, the recommendation will be for an ARCP Outcome 1, (or outcome 6 if you are at the end of a training stage eg CT2 or CT3) and that is the end of the matter for this year.

If your documentation is lacking in important respects, then you will be invited to a formal ‘ARCP panel B’ and you will be expected to attend. This is to formally work out what additional training and support you need.   We will explain to you by email what is expected of you.

Your successful ARCP will rely on the evidence you put into your e-portfolio.

The practical steps you need to take are:

1) Upload your CV into the e-portfolio. This should include, as a minimum, your full employment history, and your significant achievements.

2) Ensure that your electronic certificate of the Initial Assessment of Competence is present. Depending on training year you may also have the Initial Assessment of Obstetric Competence.

3) Completion of Unit of Training (CUT)

CT1
As a MINIMUM have the first units of the “Introduction to Anaesthesia” completed and signed off by your Education Supervisor or College Tutor.  These are:

Introduction to anaesthesia
Perioperative medicine
Preoperative assessment
a) History Taking
b) Clinical examination
c) Investigations
d) Specific pre-anaesthetic evaluation
Premedication
Postoperative and recovery room care
Perioperative management of emergency patients
Conduct of anaesthesia
Induction of general anaesthesia
Intra-operative care
Management of cardiac arrest in adults and children
Infection control

CT2
ALL units of training should be complete.

4) Your e-portfolio should show evidence of continuing, regular workplace based assessments (WPBAs). You should aim for an average of one a week.  Your WPBA’s should be accumulated continuously – not several in the last week before ARCP. Make sure you assign each WPBA to the current ARCP record.

For CT1 trainees:
Additional CUT from the Core Anaesthesia Curriculum.  If you have completed several different WPBA’s in a Unit of training module, then your Educational Supervisor/ College Tutor might complete the “Completion of Unit” sign-off.   They will be able to advise you on this. 
A link to the curriculum is here:  https://www.rcoa.ac.uk/system/files/TRG-CCT-ANNEXB.pdf

5) Keep an up-to-date logbook. This is integrated into your LLL and summaries can be generated. You MUST generate a summary and upload this as it will provide us with a recorded ‘snapshot’ of your logbook.   If you choose to keep your logbook in another form you must upload a summary version to your portfolio in the document store section.  Label it clearly, eg ‘logbook summary CT1 RLUH’

6) Ensure that your e-portfolio shows evidence of your Continuous Professional Development (CPD) or educational activities. This should be entered in the Document store section. Make sure you classify each activity in ‘activity type’ section. They can take several forms and include, for example:
a) Your attendance at local tutorials (suggested classification ‘teaching’)
b) Regional teaching e.g. BASIC, EASE and BASIC+ courses; (suggested classification ‘educational courses’)
c) Liverpool Society of Anaesthetists meetings, and other similar events (suggested classification ‘meeting’)
d) Attendance at national exam preparation courses (eg MSA courses)
e) Ensure that the e-portfolio shows evidence of your participation in Clinical Governance. This will be a record of any audit or quality/service improvement projects you have been involved in and attendance at any department audit meetings. Add audit presentations to your portfolio. (Suggested classification ‘audit or presentation’)
f) You should record your ALS status (and similar courses)

The most important thing is to include some evidence of learning – so a thoughtful commentary or reflection on what you have learned at an event is more valuable than a catalogue of dates of courses attended.

7) If you have asked for time away from training (study leave) for the purposes of teaching on a course then you must have a reflection of what you have learnt in the activities section of your e-portfolio. You must also have document with feedback from a trainer who was supervising you and feedback from the candidates. If these are missing from your e-portfolio then you will not achieve a satisfactory ARCP outcome.
NB; this does not include ‘in house’ teaching

8) Add a summary list of CPD/CME in a word file /pdf on your eportfolio. Divide it into internal and external CPD (Internal = formal teaching sessions within your base hospital plus any on line learning. External = regional and national courses.). This is a summary of items 6-7 above.

9) Reflective Practice. We expect a minimum of 6 pieces of reflection.
a) Reflection or commentary on your teaching sessions or courses attended.
b) ‘Personal reflections’.  This may arise from a clinical incident or situation, and can be linked to the appropriate unit of training (and as such will be part of the evidence used to sign off your CUT).  Remember that reflection is a tool that we use to LEARN.  Do not use information which can lead to the identification of a patient in your reflections.  If you need advice on this, or what should or should not be included speak to your ES or CT.  See also:
https://www.rcoa.ac.uk/news-and-bulletin/rcoa-news-and-statements/rcoa-provides-guidance-reflection
c) If you have been involved in an incident, complaint or SUI, please ensure there is a personal reflection to show evidence of learning. This also must be documented on your Form R.

10) Make sure that you have a Personal Development Plan (PDP) in progress on eportfolio. You will probably have one already – but make sure that it is there, and up-to-date. Make sure your PDP is entitled CT1 PDP at ‘x’ hospital and has SMART objectives (Specific, Measureable, Achievable, Relevant, Time based).  If you have completed objectives by the time of the ARCP mark them as such.

11) You might not have sat any part of the FRCA at the time of this ARCP, but if you have, you should record the attempt and its outcome in your e-portfolio. (This will be a mcq result; pass or fail)

12) Complete an MSF.  You can begin to collect feedback at any point as the MSF tool remains open until you choose to close it.  You may choose to wait until you feel people can truly comment on you – but avoid sending too close to ARCP time as consultants/ colleagues/ nurses/ ODPs etc will have multiple requests at this time and may not supply the feedback. There need to be a minimum of 12 responses.  It should reflect the whole of your practice for the year so if you have spent time in ITU or a separate attachment at LWH then include respondents from there.

13) Your educational supervisor will ask for Consultant feedback in some form. This is so they can get a picture of your performance and professionalism during theatre lists and on call and adds weight to the evidence you have already obtained for the units of training you are working towards. We don’t mind what format this takes but please load it onto your eportfolio and label it ‘Consultant feedback CT1 RLUH’ (or whatever you trust is).
This is mandatory for a satisfactory ARCP outcome.

14) ESSR in the last few weeks before the ARCP Panel A date, and once you are happy that you have completed and supplied the documentary evidence required sit down with your Education Supervisor or College Tutor and complete an Educational Supervisors Structured Report (ESSR). This is perhaps the single most important piece of evidence as it is a summary of your training in a placement. You can generate this using the LLL. It is important that you have labelled all your activities and evidence correctly so that the ESSR software can collate it in the correct place. Your ES and CT will add a commentary in the appropriate places. Please allow them enough time to do this, and it should all be complete 3 days before your Panel A date to allow us time to review it.

It is also the place where absences from work, complaints, and your involvement in Serious Untoward Incidents (SUI’s) is recorded. We all realise that the inclusion of this material is sensitive, and please note that the purpose of including it is to demonstrate engagement with the necessary processes of incident reporting, personal reflection and learning, and system improvement. This is now expected of all doctors, and it makes the ESSR a key element of your revalidation.

15) Enhanced Form R. The School Administrator will send you a link an ‘Enhanced Form R’ to complete, which will form part of your ARCP documentation. At some future date, it will be required for your revalidation. You should complete this with precise attention to detail, and return it to the Deanery. It is mainly about involvement in serious clinical incidents, investigations or complaints.  If you aren’t sure if something should be declared, ask your ES or CT.

Although the above sounds like a large amount of work, much of it should already be a routine, and it is no more than consultants are now expected to do for their annual appraisal.

Please ask if you have any questions.

Click here for a PDF checklist that you can print off and use a 'tickbox' when you are preparing for ARCP

Janet Slee
Core Anaesthetic TPD
janet.slee@sthk.nhs.uk