This is an HTML version of an attachment to the Freedom of Information request 'Consent re PAs acting beyond scope'.

 
 
 
 
NHS Grampian 
Physician Associate Intern Year 
Suite of Developmental Support Documents 
 
October 2017 (v2) 
 
 
 & 
 
 
 
 
 
 
 
 
 
 
 
 

 

link to page 3 link to page 5 link to page 6 link to page 7 link to page 8 link to page 9 link to page 10 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 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

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 

 

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) 
 
 

 


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: 
 

 


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: 
 

 


 
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: 
 

 


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.    

 


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.    
 

 


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 
 

Clinical knowledge 
 
 
 
 
 

Decision making 
 
 
 
 
Treatment actions 
 

incl practical 
 
 
 
procedures 
 
 

Record keeping 
 
 
 
 
Recognising and 
 

working within 
 
 
 
limitations 
 
Reviewing & 
 

reflecting on own 
 
 
 
performance 
 
Commitment to 
 

care and wellbeing 
 
 
 
of patients 
 
Communication 
 

with patients and 
 
 
 
relatives 
 
 
Working effectively 

 
 
 
with colleagues 
 
 
Effective time 
10 
 
 
 
management 
 
 
 
10