Formative Assessments
The Royal College of Psychiatrists sets standards for education and training, with curricula at both Core and Higher Specialist Training (HST) levels defining key capabilities essential for psychiatric practice.
Assessments, guided by sound medical education principles, are aligned with curricular outcomes.
RCPsych conducts summative assessments, including the MRCPsych exams (Papers A and B) and the CASC exam, to evaluate core curriculum knowledge and skills.
However, as detailed in the Assessment Strategy Review (ASR), certain curricular capabilities can only be reliably assessed in the workplace.
Formative workplace assessments play a crucial role in setting and developing standards for learners at all levels.
Delivered daily by dedicated Clinical and Educational Supervisors, these assessments enhance psychiatric education and, ultimately, patient care.
The work of the Formative Assessment Working Group (FAWG) deserves recognition, and clinical colleagues are encouraged to consider its key recommendations.
Introduce entrustability scales as part WBPAs. Entrustability scales are to be used within Psychiatry for Clinical Supervisor (CS) and Educational Supervisor (ES) end of placement forms.
The existing Mini PAT will be changed to Multi-Source Feedback (MSF) to bring RCPsych in line with other Medical Specialties. Along with the name change, the current number of feedback questions will reduce from 20 to 7. This would allow for a more direct link to the main overarching themes in the curricula,) HLOs and incorporating the values set out in the College’s Core Values for Psychiatrists (CR204).
Embed Formulation Skills throughout training, particularly in core training years with some additional training to be considered and scoped for Clinical Supervisors to support standardised assessment. This is integral to psychiatrists' identity as medical specialists, prevent their roles from being reduced to solely prescribing or counselling. Embedding these skills throughout training highlights their importance for both supervisors and trainees.
Introduce feedback from patients and carers for resident doctors to increase involvement of patients and carers in training and the College’s commitment to co-production. Patient and carer feedback, a cornerstone of medical appraisal systems, has historically been limited to Consultants and SAS doctors. Extending this feedback to resident doctors will better shape their training journey.
Incorporation of caseload-based discussion in resident doctors’ portfolios would be achieved by the expansion of the Direct Observation of Non-Clinical Skills (DONCS) ‘Skills observed’ dropdown box to feature HLOs 1-9. This change would allow resident doctors to capture non-clinical skills /activities that need addressing within the curriculum.
The new curricula emphasise person-centred care and public mental health, aiming to equip future psychiatrists with the skills to improve both individual patient outcomes and community mental health. This focus on formulation skills reflects the former, while the latter informs the recommendation to expand DONCS to include population-level data discussions, leadership, advocacy, and conflict management.
Acknowledgment is due to Dr. Indira Vinjamuri, Associate Dean for Curricula and Assessment, and FAWG colleagues for their contributions to strengthening education, training, and workforce quality.
The recommendation paper is now with the General Medical Council (GMC) for consideration and approval.