There have been extensive discussions within the College’s Exams and Training Committees in recent weeks to consider a variety of options on how best to assess QI in the current Covid-19 pandemic situation.
It has been agreed that the fairest and most deliverable course of action is to continue with the written submission, centrally marked by College examiners, with allowances applied to the marking of two domains. Our reasoning for this is as follows:
The FRCEM Final QIP guidance advises candidates that although the written submissions will vary, there are some common themes that are likely to appear in all QIPs in some form:
• A narrative that makes it clear how and why the topic was chosen/ identified, and what issues were identified
• A review of the local situation, possibly together with a pilot audit/study, and how outcomes and potential solutions identified
• A description of the change and/or quality management processes involved; including assessment of the need for change and selection of mechanism for change
• Evidence of engagement with stakeholders
• Development and implementation of mechanisms to assess effect of QIP
• Assessment of the effect of change including subsidiary effects
• Remedial actions following implementation
• Outcomes/effects of QIP, and possible next steps
• Reflection on the process, and the lessons learnt. This constitutes a major part of both the mark scheme, and the narrative of the QIP; it should also establish the ‘unique identity’ of the QIP
The marking of the QIPs are set against the following domains:
1. Narrative structure of written report
2. Presentation and layout
3. Engagement and team working
4. Analysis of problem/ Identification of actions required for QIP
5. Change and quality management process planning and iterative process
6. Structure and implementation of QIP and change
7. Measuring Outcomes
The Examinations Subcommittee have identified the areas where a successful QIP could lose marks due to disruption from the COVID-19 pandemic to be:
5: Change management and iterative process: marks are awarded for good planning and a clearly described process. Where candidates demonstrate the iterative process has been interrupted and they have not been able to re-start due to COVID-19 they will be asked to explain and discuss this further in the reflection section of the QIP. Allowance will be made by examiners when marking this domain.
7: Measuring Outcomes: marks are awarded for why particular metrics are chosen, what other metrics were considered but discarded, together with the continuous measurement of data to identify and eliminate variation. While final outcomes may not be available, candidates are still able to score the range of marks for this domain and allowance will be made for candidates with clearly planned strategy, even if the final outcomes are not available due to COVID-19. Candidates are advised to again explain and discuss this in the reflection section of the QIP.
Please also see the revised marksheet for further details on the allowances made to the marking of QIP impacted as a result of COVID-19.
On submission, candidates and trainers are already required to sign a cover sheet certifying that the project is the candidate’s own work and that they have correctly acknowledged the work of others. As an added reassurance on ensuring the standard of the examination where unfinished QIPs are submitted, trainers will also be required to certify the following entrustment statement:
‘Based on the material presented, the quality of the trainee’s understanding of both QI methods and their strengths and weaknesses as someone who can implement change, I believe this trainee is ready for consultant level practice in QI.’
As the ongoing impact of the pandemic on educational activity is unknown, the adjustment to the marking of the FRCEM Final QIP will apply from June 2020 until the implementation of the new curriculum from August 2021.
Dr Jason Long FRCEM