During ACCS training, some assessments are specialty-specific, and the trainee must complete them whilst working in that field. In addition to their ACCS assessments, trainees must have an electronic portfolio, if available, and can only attain one by registering with their College.
For more information on any of the below – see our page on Assessment Tools.
Assessments during ACCS training should be recorded in the e-portfolio and take the form of WPBAs, made up of a combination of
- Anaesthesia Clinical Evaluation Exercises, or A-CEXs, which can be conducted at any time, in any clinical setting, and provide immediate feedback – wherein trainees are evaluated on their clinical interaction with a patient, and assessed on their competence in providing good clinical care – including history taking, examination and clinical reasoning;
- Direct Observations of Procedural skills, or DOPSs, which assess how trainees perform when undertaking a practical procedure, providing immediate feedback;
- Multi-Source Feedback, or MSFs, which involve an assessment of trainees’ generic skills – including communication, team working, and leadership as set out in the GMC’s Good Medical Practice – and produce objective feedback from colleagues, delivered to the trainee by their Educational Supervisor;
- Case-Based Discussions, or CbDs, which assess how trainees perform when managing a patient, and skills such as clinical reasoning, the ability to make decisions, and how they apply knowledge to patient care – there is an additional focus on a written record such as the patient’s medical notes;
- Patient Surveys, or PSs, which assess trainees’ interpersonal, communication, and professional skills during a single consultation with a patient;
- Acute Care Assessment Tools, or ACATs (GIM) or (EM), which assess trainees’ performance across several domains, taking place during acute medical takes or during shifts working in the emergency department;
- Audit Assessments, or AAs, which assess how competent trainees are when completing an audit; and
- Teaching Observations, or TOs, which asseses trainees on how competent they are at formal teaching.
Assessment Combinations During ACCS Training
Trainees should have completed the following ACCS assessments: at least three A-CEXs, five DOPSs, three CBDs, and three ACATs.
Emergency medicine trainees should have completed the following ACCS assessments: at least four A-CEXs, five DOPSs, three CBDs, and ACAT.
Intensive care medicine trainees should have completed the following ACCS assessments: at least three A-CEXs, six DOPSs, and four CBDs.
During ACCS training, doctors must complete the following summative workplace-based assessments:
- A-CEX, or Anaesthesia Clinical Evaluation Exercises, completed during the first three months of training, and involving
- preoperative assessments of patients scheduled for a routine operating list – not emergency or urgent operations;
- managing anaesthesia for a patient who is breathing spontaneously, but is not intubated;
- anaesthetising a patient who is undergoing acute abdominal surgery; and
- performing rapid sequence induction and recovering a patient from anaesthesia;
- CBD, or Case-Based Discussions, involving candidates
- explaining a personal plan for anaesthesia – including the approach to pre-operative preparation, choice of induction method, maintenance of anaesthesia, and post-operative care; and
- discussing topics such as: how to correctly identify the patient and the side of operation, assessing a patient’s airway, how to predict if an intubation is going to be difficult, how to choose the muscle relaxants and induction agents to use, problems arising from emergency intra-abdominal surgery and how to deal with them, and coping with failed intubation attempt.
- DOPS, or Direct Observations of Procedures, involving candidates
- showing what the functions of the anaesthetic machine are;
- transferring a patient onto the operating table, and getting them in the correct position for surgery – wither the lateral, Lloyd Davis, or lithotomy position;
- performing cardiopulmonary resuscitation on a mannequin;
- demonstrating how to scrub and gown up;
- demonstrating basic competencies for managing pain, including the management of percutaneous analgesia (PCA), writing prescriptions, and adjusting machinery; and
- demonstrating how to deal with a failed attempt at intubation on a manikin; and
Assessment Schedules During Anaesthetics
Trainees who are completing between six and nine months of anaesthetics must complete four additional WPBAs in airway management, sedation, transfer medicine, and critical incidents.
Anesthetic trainees who are undertaking three- to six-month placements should have at least five A-CEXs, six DOPSs, and 8 CbDs, in a two-year training programme.
Anaesthetic trainees undertaking six- to nine-month placements should have at least six A-CEXs, seven DOPSs, and nine CBDs.