NHS Grampian
Physician Associate Intern Year
Suite of Developmental Support Documents
October 2017 (v2)
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Contents
Introduction ............................................................................................................................................ 3
PA Interns: Direct Observation of Procedural Skills (DOPS) ........................................................ 5
PA Interns: Case Based Discussion.................................................................................................. 6
PA Interns: Clinical Evaluation Exercise ........................................................................................... 7
PA Interns: Structured Reflection – Learning Event ....................................................................... 8
PA Interns: Structured Reflection – Clinical Event .......................................................................... 9
PA Interns: Colleague Questionnaire .............................................................................................. 10
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Introduction
A Physician Associate is a relatively new Healthcare Professional who, while not a doctor,
works to the medical model, with the attitudes, skills and knowledge base to deliver holistic
care and treatment within the general medical and/or general practice team under defined
levels of supervision. In the UK the Physician Associate is commonly a science graduate
who then undertakes a 2 year Physician Associate Programme at University.
NHS Grampian employs Physician Associates straight from University on an Intern basis for
one year at Pay Band 6 under the Agenda for Change terms and conditions. The PA Intern
will typically undertake 2 x 6 months placements under supervision and complete the
development documents outlined in this Suite of Documents. Following the Intern year, the
PA may then apply for a permanent Pay Band 7 PA post.
There is a commitment across Grampian to grow the PA Healthcare Profession because it is
recognised that there is a great requirement for this role within Healthcare to meet service
delivery requirements. The reduction in doctors and nurses and the increasing demand for
Healthcare as the population ages and grows has strengthened the desire to employ PA
Professionals to form part of the Healthcare Team. Therefore NHS Grampian have invested
in an Intern year in order to ensure newly graduated PA’s are developed and supported
within their first year and have a platform to build on in their future career with the hope they
will remain working in the Grampian area.
This document contains a suite of developmental support documents for the Physician
Associate Intern to complete during their Intern Year. The documents are similar to those of
which the Foundation Doctors are required to complete as part of their Continuous
Professional Development (CPD). By completing these recommended development
documents there will be a record within the Service as part of supporting evidence that the
PA Intern is competent within their role. The documents will form part of the PA Intern’s CPD
and Appraisal.
The NHS Grampian Appraisal system for Agenda for Change staff is via the electronic
system Knowledge Skills Framework (e-ksf). Each PA is required to populate e-ksf annually
prior to their appraisal. There is scope to up-load documentation onto e-ksf therefore once
complete the development support documents can be up-loaded. In the future there may be
the opportunity for PA’s to use the SOAR appraisal system used by Doctors but in the
interim e-ksf is available.
NHS Grampian advises that the PA Intern should undertake a recommended number of
excercises per document (over the course of the PA Intern year) as follows:
Documentation
Recommended Number
Undertaken
Direct Observation of Procedural Skills
At least one per procedure
Case Based Discussion
At least 4
Clinical Evaluation Exercise
At least 4
Reflection on Learning Event
At least 3
3
Reflection on Clinical Event
At least 3
Colleague Questionnaire
Minimum of 10
NHS Grampian recommends that the PA Intern undertakes Direct Observation of Procedural
Skills (DOPS) documentation for the following procedural skills:
□ Venupuncture
□ IV Cannulation
□ Arterial puncture in an adult
□ Blood culture
□ Subcutaneous injection
□ Intramuscular injection
□ Perform and interpret ECG
□ Perform and interpret peak flow
□ Urethral catheterisation female
□ Airway care including simple adjuncts
□ Using a nebuliser
□ Suturing (Simple interrupted sutures)
A PA is also required to undertake 50 hours of Continuous Professional Development (CPD)
per year to meet the requirements of registration with the Faculty of Physicians Managed
Voluntary Register (MVR). A CPD Diary should be completed to record the CPD and at least
25 hours should be external CPD activity. More information can be found on the Faculty of
Physician Associate pages within the Royal College of Physicians.
Examples of CPD activities include:
Work related MSc or equivalent activity (external)
Unlisted external meetings (external)
Faculty of Physician Associates examining activities (Maximum 12 External credits)
Internal mandatory training (internal)
Internal CPD meetings (internal)
Participating in audit meetings or morbidity and mortality meetings (internal)
Participating in seminars/workshops (internal)
Participating in grand rounds or specialty clinical meetings (internal)
Carrying our information searches (personal)
Presenting at a conference (personal)
Participating in Committees (personal)
Reading journals/articles (personal)
Refereeing articles (personal)
Undertaking a research project (personal)
Undertaking peer review (personal)
Writing examination questions (personal)
Writing articles (personal)
4
PA Interns: Direct Observation of Procedural Skills (DOPS)
This form should be used to record the observation, for teaching purposes, of a practical
procedure by a Physician Associate (PA) Intern and to provide feedback. Please ensure that
no patient identifiable details are recorded.
PA Intern’s Name:
MVR Number:
Date:
Procedure:
Background clinical information to provide context for the procedure:
Setting: Ward / A&E / Clinic / GP surgery / Other:
Comments on the procedure by observer:
Reflection on the procedure by the PA intern:
Agreed action:
Trainer’s details:
Name:
Position:
email address:
GMC/NMC/etc number:
Have you been trained in providing feedback? Y N
Signature:
5
PA Interns: Case Based Discussion
This form should be used to record a structured discussion, for teaching purposes, of a
clinical case where a Physician Associate (PA) Intern played a role in assessment, diagnosis
or treatment. Patients should be jointly chosen by the PA Intern and trainer. Please ensure
that no patient identifiable details are recorded.
PA Intern’s Name:
MVR Number:
Date:
Brief case summary:
Setting: Ward / A&E / Clinic / GP surgery / Other:
Comments on the discussion by trainer:
Reflection on the discussion by the PA intern:
Agreed action:
Trainer’s details:
Name:
Position:
email address:
GMC/NMC/etc number:
Have you been trained in providing feedback? Y N
Signature:
6
PA Interns: Clinical Evaluation Exercise
This form should be used to record the observation, for teaching purposes, of an encounter
between a patient and a Physician Associate (PA) Intern, and to provide feedback. Please
ensure that no patient identifiable details are recorded.
PA Intern’s Name:
MVR Number:
Date:
Clinical Interaction: History / Examination / Discussion / Other:
Background clinical information to provide context for the interaction:
Setting: Ward / A&E / Clinic / GP surgery / Other:
Comments on the interaction by observer:
Reflection on the interaction by the PA intern:
Agreed action:
Trainer’s details:
Name:
Position:
email address:
GMC/NMC/etc number:
Have you been trained in providing feedback? Y N
Signature:
7
PA Interns: Structured Reflection – Learning Event
This form can be used to record reflections by a Physician Associate (PA) Intern following
attendance at a learning event, e.g., journal club, M&M meeting, formal teaching session,
informal clinical teaching, etc. Please ensure that no patient identifiable details are recorded.
PA Intern’s Name:
MVR Number:
Date:
Title of Event:
Description of event:
What went well?
What did you learn, and what would you do differently in the future?
Action points or top learning points:
1.
2.
3.
4.
5.
8
PA Interns: Structured Reflection – Clinical Event
This form can be used to record reflections by a Physician Associate (PA) Intern following
observation of a clinical event. Please ensure that no patient identifiable details are
recorded.
PA Intern’s Name:
MVR Number:
Date:
Title:
Brief description of clinical event:
What went well?
What did you learn, and what would you do differently in the future?
Action points or top learning points (at least 3):
1.
2.
3.
4.
5.
9
PA Interns: Colleague Questionnaire
This form should be used to seek feedback from colleagues by a Physician Associate (PA)
Intern. The purpose of this form is to provide PA Interns with information about their work
through the eyes of those with whom they work. This will help PA Interns with their
development.
PA Intern’s Name:
MVR Number:
Date:
Please rate your colleague in each of the following areas. If you feel you cannot answer a
particular question, please tick “Don’t Know”.
Don’t
Category
Assessment
Any comments?
Know
1
Clinical knowledge
2
Decision making
Treatment actions
3
incl practical
procedures
4
Record keeping
Recognising and
5
working within
limitations
Reviewing &
6
reflecting on own
performance
Commitment to
7
care and wellbeing
of patients
Communication
8
with patients and
relatives
Working effectively
9
with colleagues
Effective time
10
management
10