Guidelines - Pre-employment Structured Clinical Interview (PESCI)

Transcription

Postgraduate Medical Council of Victoria Inc.
Guidelines
Pre-employment Structured Clinical
Interview (PESCI) for Hospital Based
Positions in Victoria
Updated
November 2015
Contents
PESCI Process - Overview
..................................................................................
Victorian Hospital-Based PESCI Organisational Chart
PESCI Process - Checklist
.......................................
2
.................................................................................
3
Determining need for a PESCI
...........................................................................
Position Description Requirements
4
...................................................................
5
........................................................................
6
..................................................................................
7
Position Risk Assessment Guide
Interview Process
1
Interview Panel Requirements
........................................................................
8
Conflict of Interest Statement
........................................................................
9
....................................................................
10
..................................................................................
11
Interview Question Notes and Assessment - Sample Template .........................
12
.........................
13
..............................................
23
Interview Content Requirements
Reporting Requirements
PESCI Report to the Medical Board of Australia - Template
PESCI Outcome Report to Applicant - Template
Guidelines: Pre-employment Structured Clinical Interview (PESCI) for Hospital Based Positions in Victoria
Conducting a Pre-employment Structured Clinical Interview (PESCI) for
Hospital Based Positions in Victoria
Process Overview
The Pre-employment Structured Clinical Interview (PESCI) was developed by the AMC in
2007 as part of a 2006 Council of Australian Governments’ directive to ensure nationally
consistent assessment of international medical graduates
The PESCI interview is a nationally consistent standardised process conducted according to the
AMC PESCI Guidelines and Criteria.
Resource
Victorian HospitalBased PESCI
Organisational Chart
1
Victorian Hospital‐Based PESCI * ‐ Organisational Chart
Employer recruits an IMG eligible for the
Standard or Competent Authority pathway
Employer identifies the need for a PESCI
(based on position risk assessment)
Employer does not identify the need for a PESCI
(standard employer interview conducted)
PESCI is organised and conducted by
the employer (In accordance with the
accredited interview panel criteria)
Outcome report is sent to the
applicant and employer
Interview report is sent to
AHPRA**
Employer submits registration application to
AHPRA
AHPRA assess the application and is satisfied that
the PESCI requirement has been met or is not
applicable for the position being applied for
(As per Medical Board of Australia – Limited
registration for postgraduate training or supervised practice registration standard)
AHPRA assess the application and identifies that a
PESCI is required but has not yet been organised
or conducted
(As per Medical Board of Australia – Limited
registration for postgraduate training or supervised practice registration standard)
AHPRA notifies employer that the application
will not be considered until the PESCI requirement has been conducted
Application goes to AHPRA for consideration
(the interview report arising from the PESCI is considered
Applicant is deemed to be suitable for registration(AHPRA may outline conditions associated with
the applicant’s registration)
Applicant is deemed as being unsuitable for registration
Applicant completes the registration process and
is listed as a medical practitioner on the register
IMG begins to practice in accordance with the
conditions of their registration
* PESCI
Pre‐employment Structured Clinical Interview
** AHPRA Australian Health Practitioner Regulation Agency
Visit the PESCI section of the PMCV website
www.pmcv.com.au/img/pre-employmentstructuredclinicalinterview
Interviewer Resources: Databank of interview questions; Report templates
Upcoming PESCI interviewer training workshops
Request support for a PESCI interview
2
PESCI Process- Checklist
1. Determine whether a PESCI is needed.
Assess the applicant against the position description to determine whether a PESCI is
required. (Refer to the PESCI Position Risk Assessment Guide)
PESCI required
NB: AHPRA may also determine that a PESCI is required upon assessment of an
application for registration.
2. PESCI Interview: Planning, Conducting and Reporting
Interview panel requirements met (Refer to Guidelines)
Interview content requirements met (Refer to Guidelines)
Pre-interview documentation submitted to PMCV
- Copy of position description
- Copy of applicant’s CV
- Details of interview panel (including identification of PMCV trained panel members)
- Interview questions to be used (PMCV databank of questions available to use/modify)
- Scheduled date for PESCI
PESCI Conducted
(Conflict of Interest Statement signed prior to interview by PESCI panel members)
PESCI Report to the Medical Board of Australia completed (Refer to Guidelines) and
submitted to PMCV (within 5 days) *
PESCI Outcome Report completed and sent to the applicant (within 14 days)
Interview documentation kept and filed by hospital/health service
* NB: New Requirement - PESCI report now to be sent to PMCV
for review and then PMCV will submit directly to AHPRA
(within 7 days)
3
Determining Need for A PESCI
Any IMG on the Competent Authority or Standard pathway, who is being employed into a
hospital-based position, unless it is identified as being low risk, is required to have a PESCI.
An application to AHPRA for registration is required to include either the PESCI outcome or
justification for a PESCI not being required.
Determining the need for a PESCI – Position Risk Assessment
The PMCV has developed a risk matrix to assist in determining if a PESCI is required. A flow
chart has been developed to guide hospitals/health services in their decision making regarding
whether or not an IMG requires a PESCI for a specified position.
AHPRA requires all employers of IMGs to take responsibility for determining whether a PESCI
is required and they will monitor this requirement when assessing IMG applications for
registration.
Resources
Position
Description
Requirements
Position Risk
Assessment
Guide
4
Position Description - Requirements
The Position Description:
• states the location, scope and level of the position in sufficient detail to enable a common
understanding of the responsibilities of the position by the international medical graduate,
employer, assessors, supervisor(s) and Medical Board;
• includes the demographics of the location to be worked in and local services available;
• meets the requirements of the Medical Board of Australia;
• having regard to the level of risk, states the orientation arrangements;
• having regard to the level of risk, states the supervision arrangements in sufficient detail to
enable understanding by the international medical graduate, employer, assessors, clinical
supervisor(s) and the Board;
• states the names of the principal clinical supervisor and co-supervisor(s) and their workplace
location/s;
• states the mandatory and highly desirable selection criteria.
The PESCI panel considers the position description when assessing an international medical
graduate’s ability to practise safely and competently in the position to which the applicant has
been selected for employment.
The hospital/health service has a process to categorise positions consistently according to their
level of risk. The types of position that will require a PESCI are clearly defined.
The hospital/health service obtains a curriculum vitae containing all relevant qualifications
for each PESCI applicant. The CV includes a full work experience history with no gaps in its
chronology that accounts for all working and non-working periods.
Notes: While position descriptions may vary between health services, employers must ensure
that the position description includes the items listed above.
5
PESCI Position Risk Assessment Guide - Victorian Hospital Based Positions
Hospital Based positions
Competent Authority (CA) Pathway
applicant
Standard Pathway applicant
Is the training position in a well supervised hospital environment?
HMO positions
A supervisor takes direct and principal responsibility
for individual patients.
a)
A supervisor must be physically present at the
workplace or contactable by telephone and
available to respond in person at short notice
(within 15 minutes) at all times (including after
hours) when the IMG is providing clinical care.
b)
The IMG must consult a supervisor about the
management of all patients.
Registrar positions
The supervisor shares responsibility with the IMG for
individual patients.
a)
The IMG must inform the supervisor at agreed
intervals about the management of individual
patients.
b)
If the IMGs supervisor is absent, a medical
practitioner with general or specialist
registration must provide oversight (direct
or indirect).
NO
YES
Does the applicant have previous experience in the
Will the applicant be required
to supervise other doctors?
YES
NO
YES
NO
NO
Has the applicant been out of
practice for more than 1 year
YES
Does the applicant have previous experience
appropriate to the supervisory role required
of the position?
Standard Employer
Interview Recommended
YES
NO
Accredited PESCI Required
Visit the PESCI section of the PMCV website
www.pmcv.com.au/img/pre-employmentstructuredclinicalinterview
Interviewer Resources: Databank of interview questions; Report templates
Upcoming PESCI interviewer training workshops
Request support for a PESCI interview
6
Interview Process
Planning
Conducting
Reporting
Resources
Interview Panel
Requirements
Interview Content
Requirements
Reporting
Requirements
7
Interview Panel - Requirements
For hospital-based positions in Victoria it is the responsibility of the hospital/health service to
organise a PESCI, if required.
Each PESCI Interview Panel must include:
• two medical practitioners who are appropriately qualified, preferably in the same field
of medicine as the position for the international medical graduate, have recent clinical
experience, and are completely familiar with the clinical and professional demands of the
type of position for which the international medical graduate is being interviewed;
• at least one other interviewer who may be a health professional, a lay person, or a medical
practitioner;
• at least two members of the panel have had specific PESCI interviewer training. *
The relevant documentation is to be provided to the interviewers prior to the interview. This is
to enable the interviewers individually to conduct a preliminary assessment of the applicant’s
suitability and as a group to plan the interview content (as per Interview Content guidelines)
based on the position description and defined category of risk.
Each panel member is required to sign a Conflict of Interest (CoI) statement prior to the
interview.
Documentation includes:
•
•
•
•
•
•
•
•
Position Description - (as per Position Description guidelines)
Applicant’s CV
CoI statement
Access to the PMCV databank of interview questions
Interview Content Guidelines
Interview notes template
PESCI Interview Report template to the Medical Board of Australia
PESCI Outcome Report template to the applicant
* To maintain currency of training PESCI-trained interviewers are required
to retrain after 2 years if they haven’t completed a PESCI, and 3 years if
they have been involved in at least one PESCI annually. Interviewers will
be removed from the database if these requirements are not met.
8
POSTGRADUATE MEDICAL COUNCIL OF VICTORIA INC
CONFLICT OF INTEREST STATEMENT – PESCI PANEL MEMBER
THIS DECLARATION is made on: ______________________________________ 2016
I ___________________________________ [Insert full name], as a member of the
Interview Panel for the PESCI to be conducted for:
Dr _________________________________ [Insert full name of applicant] for an:
(Intern / HMO / Registrar) position at _____________________________________
[Insert name of health service/location], declare no actual, potential or apparent conflict
of interest associated with this role.
‘Conflict of interest’ includes any situation where a PESCI panel member or the
panel member’s partner, family member, employer or close family friend has a
direct or indirect financial or other interest which influences or may appear to
influence proper consideration or decision making by the PESCI panel in relation
to the above scheduled PESCI interview.
SIGNED by PESCI Panel Member
Full name of PESCI Panel Member
Signature of PESCI Panel Member
9
Interview Content - Requirements
The content of the interview:
• is drawn, at least in part, from the secure PMCV databank of interview questions.
• is directly related to the content of the position description.
• includes a minimum of four detailed scenarios or a greater number of more simple scenarios
(either posed or experiential).
• as far as possible, simulates a patient consultation with investigation results, imaging, ECGs
etc incorporated as appropriate.
• is designed to evaluate the applicant’s capacity to respond to circumstances in each of the
following areas, as appropriate:
- Medical Interviewing skills;
- Physical Examination skills;
- Clinical Judgment;
- Treatment/Advice;
- Communication skills;
- Professionalism;
- Procedural skills.
• assesses the applicant’s knowledge of, respect for, and sensitivity towards, the social and
cultural needs of the community to be served, including those of Indigenous Australians.
Notes:
The standard expected of the applicant is one of safe practice. Interviewers are also required
to take into consideration the orientation and level of supervision and supports that will be
available in the position for which the applicant is being assessed. The panel should report on
these considerations and make recommendations around this as required.
The provider ensures that the integrity of the interview content is never compromised. It does
not provide written material that documents the interview content to the applicant, sponsor or
employer.
The interview content may include clinical simulation, hypothetical scenarios and/or clinical
scenarios from the applicant’s experience.
It is important that the interview test the applicant’s behaviours and skills necessary to perform
in the position, not just their knowledge. Behavioural interviews, which explore specific
instances where applicants have demonstrated certain skills or behaviours are used to make
these assessments.
10
PESCI Reporting - Requirements
Report to the Medical Board of Australia
The hospital/health service ensures that the interview panel use the PESCI Report to the Medical
Board of Australia template to document:
•
•
•
•
•
the interview content;
the strengths and weaknesses of the applicant’s responses;
any general concerns that arose during the interview;
whether or not the applicant is suitable for the position, giving reasons;
any specific recommendations, for example, pre-commencement courses, clinical placements
in relation to successful applicants.
The hospital/health service ensures that the report is finalised and provided to the PMCV for
review within 5 days of the interview date. PMCV will then submit directly to AHPRA within 7
days of the interview date.
The hospital/health service includes the position description and applicant CV with the report.
Outcome Report to the applicant
In the outcome report the hospital/health service documents:
• whether the applicant is suitable or not for the position, giving reasons;
• any specific recommendations, for example, pre-commencement courses, cultural training,
clinical placements in relation to successful applicants.
The hospital/health service ensures that the reports can be finalised and provided to the
applicant within 14 days of the interview date.
Review / Appeal
The hospital/health service has processes for complaints, review and appeals that are rigorous,
fair and responsive.
11
Pre-employment Structured Clinical Interview (PESCI) - Victorian Hospital-Based Position Interview Documentation
Interview Question Notes and Assessment - Sample Template
Position
Name of Applicant
Date of Interview
Interviewers
Name
Interview Question
Insert Question, e.g. Please describe a situation….
Position/Title
Situation:
Action:
Result:
Key Safety Issues Addressed:
U
Yes
No
E
S
Comments (Optional):
Key
U
Unsatisfactory
E
Satisfactory with extra
support
S
Satisfactory
Confidential: Pre-employment Structured Clinical Interview: Victorian Hospital-Based Position
12
Pre-employment Structured Clinical
Interview (PESCI)
Report to the Medical Board of Australia
IN CONFIDENCE
This report contains detailed information about the content and outcome of the PESCI. To ensure the integrity of the
interview content is not compromised this report must only be provided to the Medical Board of Australia (the Board)
and the Australian Health Practitioner Regulation Agency (AHPRA). It must not be provided to the applicant, their
employer, sponsor or other third party.
Please note: The recommendations of the PESCI panel are specific to the nominated position. An applicant who is
not deemed suitable for this position may be suitable for another position. The Board may require a PESCI if the
applicant applies to practise in another position.
Details of the PESCI conducted
Approved PESCI provider
Date of interview
Name of applicant
Position sought
Employer organisation
Position address/location
Registration type being sought
Limited registration (Area of Need)
Limited registration (Postgraduate training or supervised practice)
Provisional registration
PESCI Panel
PESCI Panel Chair
PESCI Panel members
13
Declaration of any conflicts of interest
Members of the panel discussed and confirmed that there were no conflicts of interest raised by any member
conducting the PESCI.
Background
Interview structure
Provide a brief description of how the interview was conducted and the information that was provided to the applicant
about the interview process and the process for reporting the outcome.
Add in sample of information
Applicant’s qualifications and experience
Provide an overview of the applicant’s qualifications and medical practice experience, with specific reference to their
relevance to the position for which the PESCI is being undertaken. For example, GP practice experience for a GP
position. The overview must also identify any gaps in clinical practice history and/or continuing professional
development (CPD). Where gaps in recency of practice have been identified provide information on any recent CPD
undertaken by the applicant, including dates and type of CPD.
Position description
Provide a brief description of the position for which registration is sought. This should include sufficient information to
define the level of risk. Include the location, scope and level of the position in sufficient detail to allow a common
understanding of the responsibilities for the position by the Board.
14
Describe the level of supervision that will be available to the applicant.
Medical Board of Australia supervision levels are listed below:
Level 1: The supervisor takes direct and principal responsibility for individual patients.
Level 2: The supervisor shares with the international medical graduate responsibility for individual patients
Level 3: The international medical graduate takes primary responsibility for individual patients.
Level 4: The international medical graduate takes full responsibility for individual patients.
For further information on Medical Board of Australia supervision levels click here.
Provide details about the supervision that will be provided to the applicant. Include the name/s of the principal
supervisor and any secondary supervisors and the level of supervision that can be provided.
Orientation to the position
Provide a brief description of the orientation that will be provided.
*If the above information is available in the position description, include the position description in the report.
Interview report
The applicant is required to respond to a minimum of four detailed scenarios or a greater number of more simple
scenarios (either posed or experiential). The content of the interview must be directly related to the content of the
position description.
Provide a summary of each scenario and report the applicant’s response to the scenario.
Scenario 1
Summary of scenario and applicant’s strengths, weaknesses, critical failures, omissions, any general concerns.
15
Scenario 2
Scenario 3
Scenario 4
16
Scenario 5
Assessment summary
Provide a summary of the assessments and the factors that will lead to the recommendations.
Note that the standard expected of the applicant is one of safe practice, taking into consideration the requirements of
the specific position, orientation and supervision that will be available.
17
Panel’s ratings
The panel assigns a rating for the applicant’s performance against each domain below, taking into consideration the
requirements of the specific position, orientation and supervision.
Medical interviewing skills
Facilitates patient’s telling of story; effectively listens and uses questions/directions to obtain accurate, adequate
information needed; responds appropriately to affect non-verbal cues.
Tick one box
Rating
5
Appears highly suitable for this position in this domain
4
Performance level between 5 and 3
3
Appears suitable for this position in this domain
2
1
Appears unsuitable for this position in this domain
Physical examination skills
Follows efficient, logical sequence; balances screening/diagnostic steps for problem; informs patient; sensitive to
patient’s comfort, modesty.
Tick one box
Rating
5
4
3
2
1
Not
assessed
Assessment domain not relevant to the position or not able to be assessed
Clinical judgment
Selectively orders/performs appropriate diagnostic studies, considers risks and benefits, arrives at an accurate
diagnosis or differential diagnosis and identifies effective management strategies.
Tick one box
Rating
5
4
3
2
1
18
Treatment/Advice
Explains rationale for test/treatment, plays attention to obtaining patient’s consent, and to education/counselling
regarding management.
Tick one box
Rating
5
4
3
2
1
Communication skills
Demonstrates clear, sensitive and effective communication skills.
Tick one box
Rating
5
4
3
2
1
Professionalism
Demonstrates professional values and ethical behaviours consistent with Good Medical Practice: A Code of
Conduct for Doctors in Australia.
Tick one box
Rating
5
4
3
2
1
19
Procedural skills
Demonstrates safely performing a range of procedural skills relevant to situations expected to be encountered in
the position.
Tick one box
Rating
5
4
3
2
1
Not
assessed
Other domain relevant to the position
For example, understanding of medical practice in rural areas or familiarity with social and cultural idioms.
Describe:
Tick one box
Rating
5
4
3
2
1
Panel’s recommendation/s
The report of this PESCI outcome will form part of the information that the Board will take into account when
considering whether to grant limited or provisional registration. The Board is ultimately responsible for granting
medical registration in accordance with the provisions of the National Law and the relevant registration standard.
Recommendation
Provide a recommendation about the applicant’s suitability or unsuitability for the position, giving reasons.
Suitable
(provide reasons)
Unsuitable
(provide reasons)
20
Where the applicant has been deemed unsuitable in one or more domain necessary for the position and is deemed
suitable for the position, please explain why the panel still considers the applicant suitable for the position.
Reasons
If suitable, supervision recommendation/s
The panel provides feedback about whether or not the proposed supervision arrangements are appropriate in the
circumstances. If the panel considers that the proposed supervision arrangements are not appropriate, the panel
should provide a recommendation to the Board on the appropriate level of supervision. The panel’s proposal should
be made in accordance with the Board’s Guidelines: Supervised practice for limited registration.
If suitable, recommendations relating to after hours/on call participation (if applicable)
Where a position involves after hours or on call participation, the panel is asked to provide a recommendation as to
whether the applicant is suitable to undertake these duties from the date registration is granted, or whether a period
of supervised practice should occur, prior to the applicant commencing these duties – e.g. 3 or 6 months.
21
If suitable, other recommendation/s
The panel provides specific recommendations (if necessary) for orientation, pre-commencement courses, clinical
placements or cultural training which is necessary for the applicant to practise safely and effectively in the position.
When providing recommendations about further training, the panel should specify the name of the course, the
details of the location, the duration and at which point in time the course must be undertaken by the
applicant. For example, before the start of employment or 3/6 months into the employment etc.
Signature of the PESCI Panel Chair
Date
/
/
Print name
[Insert Approved PESCI Provider Name]
Address:
Phone:
Contact Person:
22
Pre-employment Structured Clinical Interview
(PESCI)
Outcome report to applicant
This report is made available to the applicant and the Medical Board of Australia (the Board) and the Australian Health
Practitioner Regulation Agency (AHPRA).
considering whether to grant limited registration or provisional registration. The Board is ultimately responsible for
granting medical registration in accordance with the provisions of the National Law and the relevant registration
standard.
Please note: The recommendations of the PESCI panel are specific to the nominated position. An applicant who is
not deemed suitable for this position may be suitable for another position. The Board may require a PESCI if the
applicant applies to practise in another position.
Details of the PESCI conducted
Approved PESCI provider
Date of interview
Name of applicant
Position sought
Employer organisation
Position address/location
Registration type being sought
Limited registration (Area of Need)
Limited registration (Postgraduate training or supervised practice)
Provisional registration
PESCI Panel
PESCI Panel Chair
PESCI Panel members
23
Panel’s ratings
The panel assigns a rating for the applicant’s performance against each domain below, taking into consideration the
requirements of the specific position, orientation and supervision.
Medical interviewing skills
Facilitates patient’s telling of story; effectively listens and uses questions/directions to obtain accurate, adequate
information needed; responds appropriately to affect non-verbal cues.
Tick one box
Rating
5
4
3
2
1
Physical examination skills
Follows efficient, logical sequence; balances screening/diagnostic steps for problem; informs patient; sensitive to
patient’s comfort, modesty.
Tick one box
Rating
5
4
3
2
1
Not
assessed
Clinical judgment
Selectively orders/performs appropriate diagnostic studies, considers risks and benefits, arrives at an accurate
diagnosis or differential diagnosis and identifies effective management strategies.
Tick one box
Rating
5
4
3
2
1
24
Treatment/Advice
Explains rationale for test/treatment, plays attention to obtaining patient’s consent, and to education/counselling
regarding management.
Tick one box
Rating
5
4
3
2
1
Communication skills
Demonstrates clear, sensitive and effective communication skills.
Tick one box
Rating
5
4
3
2
1
Professionalism
Demonstrates professional values and ethical behaviours consistent with Good Medical Practice: A Code of
Conduct for Doctors in Australia.
Tick one box
Rating
5
4
3
2
1
25
Procedural skills
Demonstrates safely performing a range of procedural skills relevant to situations expected to be encountered in
the position.
Tick one box
Rating
5
4
3
2
1
Not
assessed
Other domain relevant to the position
For example, understanding of medical practice in rural areas or familiarity with social and cultural idioms.
Describe:
Tick one box
Rating
5
4
3
2
1
Panel’s recommendation/s
considering whether to grant limited registration or provisional registration. The Board is ultimately responsible for
granting medical registration in accordance with the provisions of the National Law and the relevant registration
standard.
Recommendation
Provide a recommendation about the applicant’s suitability or unsuitability for the position, giving reasons.
Suitable
(provide reasons)
Unsuitable
(provide reasons)
26
Where the applicant has been deemed unsuitable in one or more domain (that is necessary for the position) and is
deemed suitable for the position, please explain why the panel still considers the applicant suitable for the position.
Reasons
If suitable, supervision recommendation/s
The panel provides feedback about whether or not the proposed supervision arrangements are appropriate in the
circumstances. If the panel considers that the proposed supervision arrangements are not appropriate, the panel
should provide a recommendation to the Board on the appropriate level of supervision. The panel’s proposal should
be made in accordance with the Board’s Guidelines: Supervised practice for limited registration.
If suitable, recommendations relating to after hours / on call participation (if applicable)
Where a position involves after hours or on call participation, the panel is asked to provide a recommendation as to
whether the applicant is suitable to undertake these duties from the date registration is granted, or whether a period of
supervised practice should occur, prior to the applicant commencing these duties – e.g. 3 or 6 months.
27
If suitable, other recommendation/s
The panel provides specific recommendations (if necessary) for orientation, pre-commencement courses, clinical
placements or cultural training which is necessary for the applicant to practise safely and effectively in the position.
When providing recommendations about further training, the panel should specify the name of the course, the
details of the location, the duration and at which point in time the course must be undertaken by the applicant.
For example, before the start of employment or 3/6 months into the employment etc.
Signature of the PESCI Panel Chair
Date
/
/
Print name
[Insert Approved PESCI Provider Name]
Address:
Phone:
Contact Person:
28

Guidelines - Pre-employment Structured Clinical Interview (PESCI)

Transcription

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