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JDocs Overview

 

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Overview

As you start your early medical career, it’s important you consider what your future area of clinical practice might be.

Using the JDocs Framework and resources as you progress through your first few years in the workplace will expose you to the relevant knowledge and skills that should be achieved during the initial postgraduate years (PGY1–3).

Who does JDocs support

  • Support for prevocational doctor
  • Support for clinical workplace
  • Assessment strategies and tools
  • Overview

    Are you

    • a newly qualified doctor?
    • interested in pursuing a career in procedural medicine?
    • unsure of the requirements for specialty training?

    Any medical specialty is more than simply having a great knowledge of the body, its systems and what can harm it. Not only do you require an excellent knowledge of anatomy, physiology and pathology, you also need to have the interpersonal, professional and cultural awareness skills that allow you to listen, lead, learn, effectively communicate, make appropriate decisions, empathise and understand.

  • Where will I specialise?
    Having some idea about where you might like to specialise will allow you to get the most from your initial years of postgraduate work and experience. Similarly, you might find that surgery is not for you, however, you will be able to take the skills you have developed through JDocs into another area of clinical practice. With patient-centred care and multi-disciplinary practice at the forefront of clinical outcomes, understanding the positioning and experience of your surgical colleagues is beneficial for everyone.
  • Am I ready to apply for specialty training?
    There are a number of work-based assessments used in the clinical environment, and the College does not favour any particular type.

    To help relate the Framework to the workplace, the College has developed key clinical tasks. Each task, applicable to procedural careers, describes real clinical work that identify the skills, knowledge and attitudes that you should be able to demonstrate as you progress through the early postgraduate years (PGY). Proficiency in these tasks should be achievable by PGY3 to ensure readiness to apply for speciality training, including surgery.

    The doctor is encouraged to seek supervisor support to be observed on a number of occasions, to gauge their current level of proficiency in performing a task.  In addition to any verbal feedback, a  Supervisor may use the competencies of the framework to help guide further development of relevant skills, knowledge and attitudes to proficiently perform a task unsupervised (with supervision at a distance). Successful completion of a task at Supervision level 4 demonstrates the doctor can perform the task safely and reliably without direct supervision.

    All specialty training boards have introduced the successful completion of the GSSE as a mandatory eligibility requirement for application to SET.

Directors of clinical training, supervisors and medical education officers can use the JDocs Framework as a tool to support assessment of the prevocational doctor's progress against the relevant learning outcomes and expected levels of competency. It can also be useful in identifying gaps in learning and training, and in guiding relevant and appropriate clinical development.

Key clinical tasks have been developed to support the Framework and are intended as a guide for Supervisors to provide feedback on the workplace performance of the prevocational doctor. The Key clinical task describes the professional role undertaken by the prevocational doctor, e.g. lead a ward round. The competencies of the JDocs Framework describe the characteristics of the prevocational doctor (skills, knowledge, attitudes). Supervisors can therefore observe prevocational doctors performing a variety of clinical tasks and judge their performance against the defined standards (building blocks of the clinical work) of the JDocs Framework and provide feedback.

Key Clincal Tasks in your hospital

  • Interns
    Doctors could be assessed at the beginning and/or end of their internship to gauge their progress in Leading a Ward round? Are they ready to move to entrustment Level 2?
  • JHOs/HMOs
    Use as a benchmark for doctors transitioning from Intern to PGY2 - can they competently perform a Ward Round under direct supervision?
  • SHOs/RMOs
    Gauge level of doctors’ performance and provide guidance and feedback to help progress to supervision level 4.
  • PHOs
    Use as a benchmark for those doctors transitioning to an unaccredited role to ensure they can demonstrate expected standards and performance required.
  • (unregistered registrars)
    The surgical unit could select a number of key clinical tasks they see as high priority for doctors to be able to perform unsupervised as they transition to the unaccredited role (SET ready).

The College will continue to collaborate with hospitals to discuss further the ways in which the JDocs Framework can be recognised to complement existing prevocational training programs and identify opportunities for feedback and assessment.

A range of work-based assessments are used for prevocational doctors around Australia and Aotearoa New Zealand.  JDocs does not favour any one type of assessment, as there will be a variety of ways and clinical situations in which a prevocational doctor will be able to demonstrate they have met the learning outcomes at the standard required.

Regular feedback/assessment is recommended and, consequently, the range of assessment strategies detailed below should help the prevocational doctor describe progress, including feedback on performance of the key clinical tasks.

The following assessment strategies have been provided as examples. Doctors are encouraged to check with their Director of Clinical Training and/or Head of Clinical Unit about the relevant tools and how to access these.

  • Direct observation
    • Key clinical tasks – Guidelines for feedback of daily professional activities undertaken by the prevocational doctor at the early registrar level.
    • Direct observation of procedural skills (DOPS) – A method of assessing performance during routine surgical practice in wards, outpatient clinics and operating theatre. The College has provided a sample of a DOPS form which will vary in format by hospital.
    • Mini-clinical evaluation exercise (Mini-CEX) (Link TBC)– A formative assessment that involves the clinical assessor observing the junior doctor interacting with a patient in a normal clinical encounter. The College has provided a sample of a Mono-CEX form which will vary in format by hospital.
  • Multi-source Feedback
    Multi-source feedback tool (MSF) – Hospitals will have different approaches to this area of work-based assessment; where done consistently, the reports could be noted in the ePortfolio (with permission).
  • Summative work-based assessments

    Progress reports from each rotation.

    • Mid-year and end-of-year term assessments.
    • The format of these will vary in Australian and New Zealand hospitals; regular, structured assessment that complements more frequent formative feedback is favoured
     

     

  • Simulation

    Participation in, and evidence of, completion of training simulation courses, for example:

  • Reflective learning tools and learning portfolios
  • Summative Assessment

    Generic surgical science examination (GSSE)

Why JDocs