Assessments and appraisals


There will be regular appraisals and assessment during ACCS training which is both formative and summative. Progress at various points in ACCS training is dependent on successful assessment. The timing and format of appraisal and assessment will vary for each specialty specific module and will be in accordance with the requirements specified in individual specialty CCT programmes.

Summative vs Formative assessment

A number of the specialty specific assessments are summative and are used to provide a formal assessment of the required knowledge, skills and attitudes. These assessments must be retaken if any aspect is failed by the trainee. The specific summative assessments are indicated on the home specialty pages. The other assessments are formative and used mainly as a learning and assessment tool in a less formal manner.

Important points:

  1. Successful completion of the Acute Care Common Stem (ACCS) programme and progression to the next stage of training requires satisfactory progress in all parts of the ACCS elements, regardless of the intended future career pathway.
  2. Each element requires a large number of assessments (typically 1-4 each month) and trainees should be strongly encouraged to complete assessments regularly throughout the programme.
  3. The assessment system is trainee driven and they should liaise closely with their trainers/Educational Supervisors regarding progress through the assessments.
  4. Assessments should ideally be supervised by trainers, but may on occasion be delegated to senior trainees (currently SpR4/5 and in future ST5/6).

Educational agreement and appraisal

Each trainee must complete an educational agreement with their supervisor within two weeks of the start of each placement. This should clearly establish the training goals of the placement and forms part of the basis of subsequent review. There should be continuing regular appraisal throughout the period and every trainee must have a formal appraisal at the end of the period with each specialty.

Specialty Specific Competencies and Assessments

Each of the four specialties has specific competencies that need to be achieved during the module. For both Anaesthesia and Intensive Care there are separate competency documents that are required in order to successfully complete these training modules. The generic work place based assessments (below) should be used as tools to assist in your training and to provide evidence for your portfolios.

Work Place Based Assessments

Trainees will be assessed in the workplace using a range of assessment tools to be completed by different (sometimes multi-professional) assessors. The assessment methods are described below and will be used in different ways by different specialties. The number of forms needed also varies by specialty and Deanery/LETB. While completing the minimum number of assessment forms is one requirement for a successful outcome from the ARCP, it may be necessary to complete many more assessments in order to show competence throughout the curriculum.

  • Mini Clinical Evaluation Exercise (mini-CEX) or Anaesthetic-CEX (A-CEX) - is a work place based method where direct observation of a trainee’s clinical skills during an everyday clinical encounter is assessed. These skills include medical interviewing ability, communication and clinical judgment and vary depending on the specialty.
  • Case Based Discussion (CbD) - is a discussion generally in a reasonably formal setting centred on the trainees reflection on his/her patient notes. The discussion will bring out key messages of trainees’ knowledge, case management, diagnostic skills and planning etc. A CbD might be included as part of case presentations at department meetings dependent on the specialty.
  • Directly Observed Procedural Skills (DOPS) - is a clinical encounter evaluating the trainee’s competence in a particular procedure, for example central line insertion, tracheal intubation or primary sutures.
  • Multi Source Feedback (MSF) - is a version of the 360 degree assessment. A number of multi-disciplinary assessors anonymously score a trainee against a number of domains mostly concerned with attitudes and behaviours.
  • Acute Care Assessment Tool (ACAT (GIM), ACAT (EM)) - the ACAT is designed to assess and facilitate feedback on a doctor’s performance across a number of domains. The ACAT (GIM) is designed for use during  an Acute Medical Take. Any doctor who has been responsible for the supervision of the Acute Medical Take can be the assessor for an ACAT. The ACAT (EM) is a modified version designed for use across shifts worked in the Emergency department. The ACAT tool on any one occasion can be used to cover a number of acute presentations.
  • Patient Survey (PS) - a Patient Survey identifies issues including behaviour of the doctor and effectiveness of the consultation which are important to patients. It is intended to assess the trainee’s performance in areas such as interpersonal skills, communication skills and professionalism by concentrating solely on their performance during one consultation.
  • Audit Assessment Tool (AA) - the Audit Assessment Tool is designed to assess a trainee’s competence in completing an audit. The Audit Assessment can be based on review of audit documentation OR on a presentation of the audit at a meeting. If possible the trainee should be assessed on the same audit by more than one assessor.
  • Teaching Observation (TO) - the Teaching Observation tool is designed to provide structured, formative feedback to trainees on their competence at teaching. The Teaching Observation can be based on any instance of formalised teaching by the trainee which has been observed by the assessor. The process should be trainee-led (identifying appropriate teaching sessions and assessors).

The Assessment Forms page contains information both on specialty specific and generic work place based assessments.

The completion of the WPBAs and other assessments is the trainees responsibility, if no documentation is produced for the ARCP it is very likely that the trainee will fail to progress.