Thirdly, when training programmes move towards competency-based summative assessments it can be used by the trainee as evidence of competence: if the most recent CbDs are all at the level of trusting the trainee without supervision, then this is evidence that they are ready for independent practice.
Almost everyone involved in higher specialist training discusses cases with their trainees as part of the training process. Informally, this will be done during or after a ward round, or in an outpatient clinic: the trainee presents a summary of the case to his supervisor, who critiques and approves or adjusts the decision-making. It is often an opportunity to teach at the same time. There may be departmental meetings in which trainees present a case (often selected for clinical interest or rarity) for discussion with their colleagues and supervisors. How is this concept different?
Time constraints are the usual factor limiting the numbers of CbDs being undertaken. One session of 20–30 min every 2 or 3 weeks might be an achievable goal. Of course, the informal case discussions will continue as before; this form of structured CbD is an additional tool which can help to structure and document training and identify developmental needs.
Who should do it?
An example of a supervisor subjective rating of level of trust
Conflict of interest: N. Gibson has nothing to disclose.
The conventional model of different levels of assessment is Miller’s pyramid (figure 1) in which the lowest level is factual knowledge (“knows”), followed by integrated knowledge (“knows how”), then “shows how”, demonstrating competence in a simulated situation, and finally “does” . It is this final level which we attempt to assess in WBA, exploring the way in which a clinician performs in normal practice. The advantage of this type of assessment is that it can take into account knowledge, skills and attitudes, and gives a realistic picture of actual performance, so it has a high validity. The disadvantage is that it is less reproducible than a simple cognitive assessment such as a multiple-choice examination and introduces the subjectivity of the assessor.
What is case-based discussion?
At the end of the session, the supervisor should spend a few minutes giving feedback to the trainee about what was done well and what might have been done better or differently. It is then important to suggest and then agree what might be useful actions for learning or development. It is often helpful to start this discussion by asking the trainee for their views on what they did well and what they were less happy with, as they are often aware of their own development needs.
All medical graduates are used to summative assessment: the final examinations at the end of medical school, postgraduate examinations or an oral defence of a research thesis. The objective of a summative examination is a simple, usually binary outcome, pass or fail. In clinical practice the question is whether the trainee is competent to progress to the next stage of their career. Formative assessments are more of a training tool, used to identify the strengths of a trainee, and more importantly, the areas in which they need to improve their performance and develop their skills. They fulfil a teaching function in which the trainee is an active participant but can also be used to feed into an assessment of competency. While these types of assessments are probably happening informally during many of the normal working interactions between the supervisor and trainee, they can be much more useful if they are formalised and there is some record of the interaction. Formative assessment is most useful when it is a direct assessment of real-life functioning in the workplace, i.e. workplace-based assessment (WBA).
Methods: A pretested 17-question survey was distributed at the point of care at 2 community pharmacy locations and at hemp oil-based CBD education presentations over a 3-month period. The survey consisted of multiple-choice, open-ended, and select-all-that-apply questions, which were analyzed using univariate and bivariate analyses.
Results: A total of 101 participants completed the survey: 38 were CBD-naive, and 63 were CBD-exposed. Most of the participants were women (79%) and Caucasian (81.6%), with an average age of 59 years (SD 17.26). In the CBD-naive group, the most commonly stated barrier to using hemp oil-based CBD was not enough information about the product. Among the participants who had used or were using at least 1 CBD product, the most commonly used dosage form was sublingual, followed by topical: 46 (46/63 [73%]) and 34 (34/63 [54%]) participants, respectively. Thirty-eight participants used hemp oil-based CBD for pain, 24 participants for sleep, and 17 participants for anxiety. Of these, 62% of the participants informed a health care provider that they were using a hemp oil-based CBD product.
Background: The Agricultural Improvement Act of 2018 legalized the commercial use of hemp-based products, including cannabidiol (CBD). However, the U.S. Food and Drug Administration (FDA) does not currently regulate the commercial sale of hemp oil-based CBD, and there is no FDA-approved indication for its nonprescription formulations despite the growing demand for, and use of, hemp oil-based CBD.
Conclusion: The participants were using different brands and formulations of hemp oil-based CBD for multiple reasons. The greatest barrier to trying CBD was limited education, which may suggest a need for community education about hemp oil-based CBD products.
Objectives: Characterize the use of hemp oil-based CBD, including brands, formulations, and reasons for use, in a community pharmacy setting and identify the perceived barriers related to the use of hemp oil-based CBD.
Copyright © 2021 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Suggested CAT formats
This has to be completed and submitted with you prospective CBD cases to your Trainer. It details the competencies you feel you have demonstrated and why. This helps focus the CBD and increases the likelihood of you achieving those competencies.
Who can assess you?
The CbD should be carried out by a consultant, an associate specialist or experienced registrar in the speciality concerned (ST4 or above ). In GP The CBDs should be carried out by trainers approved by the GP school as Clinical and Educational supervisors.
As a GP trainee, you’re responsible for selecting cases, requesting a CbD and ensuring the paperwork is completed properly. You and your CS should ensure that your ePortfolio reflects a balance of cases, including:
Below are suggested events that may be assessed as CATs, with details of the preparation required in advance, the content of the assessment, the Capabilities that may be assessed and the recording required.