Practice Experience Program (PEP) · 2020-03-10 · Practice Experience Program (PEP): Mentor guide. Version 2020.2 Disclaimer The information set out in this publication is current

Practice Experience Program (PEP) Mentor guide

Version 2020.2

racgp.org.au Healthy Profession.

Healthy Australia

Practice Experience Program (PEP): Mentor guide. Version 2020.2

Disclaimer

The information set out in this publication is current at the date of first publication and is intended

for use as a guide of a general nature only and may or may not be relevant to particular patients

or circumstances. Nor is this publication exhaustive of the subject matter. Persons implementing

any recommendations contained in this publication must exercise their own independent skill or

judgement or seek appropriate professional advice relevant to their own particular circumstances

when so doing. Compliance with any recommendations cannot of itself guarantee discharge of the

duty of care owed to patients and others coming into contact with the health professional and the

premises from which the health professional operates.

Accordingly, The Royal Australian College of General Practitioners Ltd (RACGP) and its

employees and agents shall have no liability (including without limitation liability by reason of

negligence) to any users of the information contained in this publication for any loss or damage

(consequential or otherwise), cost or expense incurred or arising by reason of any person using or

relying on the information contained in this publication and whether caused by reason of any error,

negligent act, omission or misrepresentation in the information.

Recommended citation

The Royal Australian College of General Practitioners. Practice Experience Program (PEP):

Mentor guide. Version 2020.2. East Melbourne, Vic: RACGP, 2020.

The Royal Australian College of General Practitioners Ltd

100 Wellington Parade

East Melbourne, Victoria 3002

Tel 03 8699 0414

Fax 03 8699 0400

www.racgp.org.au

ABN: 34 000 223 807

ISBN: 978-0-86906-511-2

Published November 2018; updated April 2019, February 2020, March 2020

© The Royal Australian College of General Practitioners 2020

This resource is provided under licence by the RACGP. Full terms are available at

www.racgp.org.au/licence. In summary, you must not edit or adapt it or use it for any commercial

purposes. You must acknowledge the RACGP as the owner.

We acknowledge the Traditional Custodians of the lands and seas on which we work and live, and pay our respects to Elders, past, present and future. 20664.1.13

https://www.racgp.org.au/licence-terms

Practice Experience Program (PEP) Guide for participants 2018–19 1

Practice Experience Program (PEP) Mentor guide

Version 2020.2

ii Practice Experience Program (PEP) Mentor guide

Contents

Introduction to the Practice Experience Program 1

The mentoring role in the PEP 1

Definition 1

Qualities of a PEP mentor 1

Roles and responsibilities of a mentor 2

A PEP mentor is not a clinical supervisor 2

Mentor tasks 2

Regular meetings 3

Information for MEs helping participants make a program determination 4

Process for the discussion 4

Learning plan 6

Learning units 7

The learning program 8

Multisource feedback (MSF) discussion 10

Completion of the program 10

Reporting on progress 11

Raising concerns 11

Maintaining boundaries 11

What to do if things go wrong 11

Conflicts of interest 11

Confidentiality 11

PEP evaluation 12

Acronyms and initialisms 13

Definitions 13

Reference 14

Appendix A. Background information – Summary of the Practice Experience Program 15

Appendix B. List of PEP learning units 18

Appendix C. Learning unit assessment form (template) 19

Appendix D. Learning unit assessable task rubric 20

Practice Experience Program (PEP) Mentor guide 1

Introduction to the Practice Experience Program The Practice Experience Program (PEP) is a self-directed education program designed to support non–

vocationally registered (non-VR) doctors on their pathway to Fellowship of The Royal Australian College of

General Practitioners (FRACGP). The PEP aims to provide targeted educational support for non-VR doctors

to support their learning and provide feedback on their progress towards achieving FRACGP.

The PEP is different to the Australian General Practice Training (AGPT) Program, in that it is an educational

support program with an emphasis on self-directed learning. Participants come from a variety of backgrounds,

with a variety of skills sets. They work in various practice settings, including remote practice, after-hours and

locum services. Their program is therefore individualised and not structured to the group as occurs in AGPT.

In addition, not all participants in the PEP have access to supervisor support or in-practice teaching, but they

receive support in other ways. Unlike AGPT where exams are completed during the program, PEP participants

cannot sit the exams while they are in the program. From January 2022, it will be compulsory that all FRACGP

exam candidates complete a recognised program in order to be eligible to enrol in the exams.

The PEP is delivered in partnership with training organisations (TOs). The PEP is a 3GA program funded by the

Department of Health for which provider numbers can be issued (location restrictions apply). Participants make

a co-contribution payment each term.

The mentoring role in the PEP

Definition

Mentoring is defined as a professional relationship in which an experienced person assists another to develop

specific skills and/or knowledge important for their professional and personal growth.

Effective mentoring requires the development of a sound collaborative professional relationship that provides the

opportunity for reflection and discussion.

In the PEP, the role of the mentor is to support learning and program planning, review and discuss assessments

with participants, encourage self-reflection, and provide support and advice about the program. The ultimate aim

is to assist the participant in developing the broad range of competencies outlined in the RACGP Curriculum for

Australian General Practice 2016 that are essential for independent, competent practice in Australia. Mentoring is

an important component of the PEP, as it provides support and guidance for participants during their training.

The PEP mentor role has several components and activities, which might be undertaken by one person or a

number of different people. The mentor role will vary depending on the TO and local context.

Qualities of a PEP mentor

The PEP mentor should ideally:

be an experienced medical educator (ME) where clinical expertise is required

have knowledge of, and experience in, working with doctors who are progressing towards FRACGP

have knowledge of the PEP, including the requirements and policies

have active listening skills

have the ability to deliver constructive feedback

have the ability to identify learning barriers and help resolve issues

be flexible, supportive and empathic.

https://www.racgp.org.au/education/education-providers/curriculum

https://www.racgp.org.au/education/education-providers/curriculum

2 Practice Experience Program (PEP) Mentor guide

Roles and responsibilities of a mentor

The PEP mentor will:

provide a professional relationship

provide non-judgemental advice

encourage self-reflection

encourage problem solving and listen, motivate and inspire

be available at agreed times

refer to appropriate avenues if problems develop

act professionally at all times

identify participants requiring additional support

maintain confidentiality, where appropriate.

A PEP mentor is not a clinical supervisor

Supervision is defined as ‘the provision of guidance and feedback on matters of personal, professional and

educational development in the context of a trainee’s experience of providing safe and appropriate patient care’.1

Clinical supervision can be considered as a requirement to ensure the safety of patients who are seen by a

trainee. Educational supervision is undertaken when helping the trainee to learn.

Some, though not all, PEP participants will have a nominated supervisor. In contrast to AGPT, these supervisors

are not accredited by the TOs, but instead are in place as part of the participant’s medical registration

requirements. These supervisors are not required to provide educational supervision of the PEP activities.

PEP mentors, by contrast, provide support and advice on aspects of the PEP, but do not provide clinical advice or

take the place of a counsellor or treating doctor. PEP mentors are not to become de facto clinical supervisors, a

fact that needs to be made clear to participants from the outset.

The mentor role should also be differentiated from that of a clinical assessor who undertakes the clinical

assessments that form part of the workplace-based assessment (WBA) program. The role of the mentor, in

relation to the WBA, is to review assessment reports, consider how the participant is progressing, and provide

guidance and support to the participant. The multisource feedback (MSF) debrief and discussion is also one of

the mentor tasks.

Mentor tasks

There are number of identified tasks for the mentor. This does not mean that all of these tasks would be

undertaken by one person; rather, this reflects the overall program requirement.

Table 1 outlines the requirements for each participant.

Table 1. Participant requirements

Item Frequency Description

Learning units

ME discussion

of learning

program

Once in first three

months of program

commencement

and once towards

the end of Term 1

This includes:

discussion of Initial Core Skills Analysis (ICSA) results

discussion and confirmation of learning program in terms of time and

units (program needs to be confirmed at least one month before the

end of Term 1)

review of learning plan.


ME discussion

and

assessment of

learning units

Regularly

throughout each

PEP term

This includes:

regular review of learning units as undertaken by the participant

assessment of learning units and other PEP activities as required

provision of feedback.

Mentoring and reporting

Mentoring and

review of

participant

progress

Regularly

throughout each

PEP term

As a minimum, this includes for each participant:

a minimum of two meetings in Term 1 with each participant (including one meeting within the first month of the first PEP term, and one later in Term 1 before the program confirmation is submitted) and a minimum of one meeting in each subsequent term

regular review of assessments and clinical examination and procedural skills logbook (findings discussed at regular term meetings)

regular review of the participant’s learning plan

reviewing and providing feedback on MSF, which is completed once only during PEP participation (to be discussed at a regular term meeting).

Contribute to

the participant

progress

report

Once per PEP term This summarises a participant’s overall program status, including:

a progress summary with reference to the PEP’s objectives and the participant’s program agreement

any other relevant information and feedback.

The TO must use the prescribed template, with mentors providing input into this report.

Regular meetings

The PEP includes a number of regular meetings, including a minimum of:

two meetings in Term 1 with each participant, with the first meeting taking place within the first month of commencing the PEP, and the second later in Term 1 before the program confirmation form is submitted

one meeting in each subsequent term.

These meetings should take up to one hour.

The first meeting frames the rest of the meetings. It would be useful to establish the objectives for the meetings

so the participant is clear on what needs to be covered and achieved in the time allocated for the meeting. In

addition to objectives, it is good to spend some time setting the boundaries (ie what can and cannot be done) and

expectations from the program. It is also important to establish how contact will be made (eg via TO email, phone,

PEP portal discussions).

The outcomes of the Initial Core Skills Analysis (ICSA), including the individual learning program and the self-

reflection, should be reviewed and discussed at the first meeting. These will form the basis of the initial

development of a learning plan.

In Term 1, participants commence the core units. They will need to select their units for the remainder of their

program by the end of that term. In addition, they can vary their program time. Both program time and units need

to be discussed with the participant, and the meeting is an opportunity to guide reflection about the program.

The meeting at the end of Term 1 is essential in helping participants finalise their program. Further detail is

included in the following section.

The content of subsequent meetings includes a discussion about progress on WBA, feedback about learning

units, review and update of the learning plan, logbook review and discussion about any particular program issues

that have arisen.


Information for MEs helping participants make a program determination Participants in the PEP Standard Stream have the option to increase or decrease their program time by one term

between the minimum (two terms) and maximum (five terms). It is expected that five learning units will be

completed during each term.

An increase in program time will allow extra time to work in general practice, and will include extra learning units

and WBAs.

A decrease in program time will reduce the number of learning units, and there will be fewer WBAs and less time

working in general practice.

The core units are mandatory and commence in Term 1, but participants need to nominate their remaining

learning units. This decision needs to be made for the program confirmation form to be submitted, hence it occurs

later in Term 1. For participants to make an informed decision about their learning program, they need to be able

to discuss their choices with an ME. That discussion and the outcomes are recorded on the PEP portal.

Background information about the PEP is included in Appendix A.

Process for the discussion

Contact the PEP participant and organise a time to discuss their program. This meeting needs to happen before

the program confirmation form is submitted and once the direct observation and case discussion have been

completed, as information from these assessments will form part of the discussion. It can be done as a face-to-

face or distance meeting.

Once a discussion has been completed, the participant will fill out the program confirmation form on the PEP

portal. This is a record of their decision in respect to their learning program time and units. The form needs to be

submitted at the latest by 20 business days from the start of Term 2.

The ME is not expected to make a decision on behalf of the participant, but to help them decide the length and

content of their program. If the ME does not agree with the final decision made by the participant, this should be

noted at the time of acknowledging their submission on the form by leaving a note in the comments section.

Sources of background information to assist MEs and key issues to discuss with participants are listed below.

Sources of information

There are a number of sources of information to inform the discussion.

Personal factors such as insight into performance, factors affecting ability to complete the program or expectations will be evident from a discussion with the participant

Assessment results should be available on the PEP portal.

Recommendations may be available from an ME or the TO.

Checklist of areas to discuss

Key areas and points to discuss with participants include the following:

current decision and reasons

assessment results – PEP Entry Assessment (PEPEA), ICSA, WBA, learning units, MSF (if available)

any recommendations from MEs and/or TO made in relation to progress

barriers (and likelihood of these to change – ongoing or otherwise)

insight into personal skills and weaknesses and identified learning needs

consequences and understanding of the decision.

More detail about the questions and areas for discussion are included in Table 1.


Table 1. ME discussion with participant: Areas for discussion

Topic Questions Considerations

Current participant

decision and

reasons

What is the current decision?

What are the reasons for this decision?

What are the expectations of the

decision?

If the expectation is to allow extra time to

complete unfinished work, extra work will be

allocated in regard to learning units and WBAs

If the expectation is that leaving the PEP early

will allow the participant to sit exams, there may

be consequences if they are unsuccessful and/or

wish to reapply to PEP in the future. Repeating

PEP incurs greater costs (refer below). It is also

important that the participant be aware of the

requirements to be exam eligible.

Assessment

results – ICSA,

WBA, learning

units, MSF

(if available)

What were the ICSA results?

Related to time

MCQ scores and any mismatch in confidence levels

Any potential issues, such as limited scope of practice

How do these results accord with the decision

and understanding of the participant?

What are the results of the WBA?

Are they at the standard expected, or above or below?

Has remediation been recommended?

What feedback about performance has been given?

How do these results accord with the decision

and understanding of the participant?

If below the standard, are there reasons for this

(eg personal or practice factors)? If so, do these

reasons still exist or has the situation changed?

What are the results of the learning unit

assessments?

Have the participant’s current units been completed or are they expecting that they will be able to complete these in extra time?

Have they met the expected standard?

Are there additional learning areas that they have identified?

Reducing time in the PEP will mean less time to

complete unfinished tasks.

Additional time will allow the participant to

complete more units if they have identified extra

learning areas.

Training

organisation (TO)

Have any recommendations about time

and units been made by the TO?

Is the participant aware of these

recommendations?

Do these support or contradict the participant’s

decision?

Has the participant engaged in the

program? If not, will this continue or is

change expected?

Lack of engagement may result in not completing

the program satisfactorily, which impacts provider

number access.

Barriers/difficulties

in the program

Are there barriers to learning or

performance that have affected results

to date?

Barriers to learning may indicate the need for

extra support or remediation.

Will these change in the remainder of

the program?

Ongoing barriers may result in not completing the

program satisfactorily and if not addressed affect

future performance in exams

https://www.racgp.org.au/education/registrars/fellowship-pathways/policy-framework/policies/practice-experience-program-exam-eligibility

https://www.racgp.org.au/education/imgs/fellowship-pathways/policy-framework/policies/practice-experience-program-remediation


Insight into

personal skills and

weaknesses

What is the participant’s personal

opinion of their standard compared to

the opinions of MEs in the WBA?

The standard to be met is that expected in the

exams. Mismatch in opinions may indicate

participant lack of insight into the required

standard against current level. Can they identify areas that they need to

work on in order to reach the standard,

and how do these compare with

recommendations from the MEs or TO?

Consequences

and understanding

of decision

How will changing the program time

affect learning units and assessments

required?

An increase in program time will allow extra program time and will include extra learning units and WBAs.

A decrease in program time will reduce the time available to complete learning units or assessments if these have not been done in Term 1

Exam eligibility – how will the time

changes impact exam eligibility?

A GPE assessment is required in order to

accurately assess exam eligibility. This cannot be

estimated based on the participant’s CV, as

various factors affect the assessment.

What is the impact on future program

eligibility?

If a participant fails their exams and wishes to

reapply for the PEP, it is important to remember

that decisions to accept a participant back into

the program are made at the discretion of the

RACGP. Issues such as failure to participate in

the program or reducing program against advice

might be considered.

Will the changes impact provider

numbers?

Provider numbers can be continued for three

years after the program if it is completed

satisfactorily. If the program is not completed

satisfactorily, provider number access through

the program is discontinued.

How will the changes impact program

costs?

Increasing or decreasing program time affects

the costs paid. In addition, any participant who

leaves the program but later reapplies and is

accepted will not be eligible for a funding subsidy

from the government, so will need to meet the full

costs of the program.

CV, curriculum vitae; ICSA, Initial Core Skills Analysis; ME, medical educator; MCQ, multiple choice question; MSF, multisource

feedback; PEP, Practice Experience Program; RACGP, Royal Australian College of General Practitioners; TO, training organisation;

WBA, workplace-based assessment

Learning plan

It is the participant’s responsibility to engage with the learning program and drive their own learning. The mentor’s

role is to provide support.

Reviewing the participant’s logbook, learning plan, WBA reports, learning unit assessment tasks and learning unit

progress provides evidence of engagement and gives an indication of how the participant is progressing. The

learning plan should include evidence that the participant is reflecting on feedback from all program activities, and

using this feedback to develop action items.

The participant learning plan is accessed online, and the mentor is able to review and comment on the learning

plan via the PEP portal.



Participants should be encouraged to consider focus areas for each term, taking into consideration:

ICSA results, including the self-reflection

learning units completed

feedback from assessments

mentor discussions.

Once the focus areas are identified, the participant then considers:

actions (‘What will I need to do?’)

timelines (‘When will I complete this?’)

support and resources required (‘How will I do this?’)

measurement of progress (‘How will I measure my progress?’).

Participants are encouraged to document a minimum of four and maximum of 10 action items per term.

The learning plan should be updated at least every six months.

Learning units

The role of the PEP mentor includes:

regular review of learning units as undertaken by the participant

assessment of learning units and other PEP activities as required, as well as provision of feedback.

The mentor will have access to the learning units via the RACGP portal and learning management system (LMS),

and will be able to provide their feedback via the portal assessment form.

Educational background to the learning units

The program promotes self-directed learning by encouraging regular reflection about personal knowledge and

skills. The learning units include a series of tasks that are undertaken in clinical practice in order to make the link

between the acquisition of knowledge from online learning and application into the individual’s context.

For learning to occur, it needs to be accompanied by feedback and reflection. Further, completion rates of online

programs can be low unless there is support from other sources. Participants therefore need the opportunity to

discuss and receive feedback about the activities they complete while in the program. In addition, participants are

encouraged to reflect on feedback received, specifically about what further learning might be useful, and to

document this in their learning plan, which is maintained throughout the program.

Structure of the learning units

More than 30 learning units have been developed and are mapped against the RACGP curriculum. Each unit

equates to approximately 30 hours, so it is expected that five units be completed each six months. All activities

in the unit aim to extend and apply skills rather than simply build theoretical knowledge.

The individual units address important aspects of the topic but are not intended to be exhaustive in their

coverage. Participants are encouraged to extend their learning through a list of resources that accompanies each

unit, although they are not expected to read all of the resources provided. Some units cover similar areas – for

instance, women’s health, pregnancy care and sexual and reproductive health. What may appear to be missing in

one unit might be covered in a related unit. Every attempt has been made to eliminate unnecessary duplication.

https://www.racgp.org.au/education/registrars/fellowship-pathways/curriculum/2016-curriculum


Each unit has three key components:

1. Online learning activities.

2. In-practice activities – for example, case studies, clinical audits, reflective pieces, literature analysis, review of

practice policies and procedures, or review of clinical documents such as referral letters. A number of units

ask participants to produce case studies. A case study template is provided for this purpose.

3. A reflection on learning from the activity and its application to practice, and a further reflection on any future

learning activities that can be included in the learning plan.

The PEP Specialist Stream learning units are similar, although the final reflection is optional.

For the PEP Standard Stream, one of the in-practice activities is the ‘assessable’ activity – that is,

participants receive feedback about their work on this activity from an ME. Participants are not aware which

activity is assessable in each unit.

In the PEP Specialist Stream, participants write a final reflective essay about their learning and experience.

This is assessed by the ME and feedback is provided.

The learning program

The learning units that a participant completes form their learning program. Of the units, there are seven core

units that are completed by all participants. The remaining units are elective; participants can choose which of

these they will complete. In choosing units, participants are encouraged to consider their ICSA results, previous

experience, current learning and practice needs and previous learning.

A full list of learning units is included in Appendix B.

The assessable tasks

The assessable tasks within the learning units vary but usually consist of either:

case studies, or

reflective pieces – about an activity such as an audit, review or visit and its application to individual practice.

Exemptions

The RACGP is reviewing the exemptions process in order to take into account any prior learning undertaken by

the participant. This guide will be updated accordingly.

Assessing the tasks

In any assessment task, it is important to know:

the standard expected

how results will be used (whether for feedback or a pass or fail assessment)

what aspects of the answer are to be assessed – marking rubrics may be provided to help guide the assessor in their decision making.

For assessable tasks, the standard expected is that which would be expected of a competent general practitioner

(GP) as this is the standard that participants need to meet in order to attain Fellowship. There is no pass/fail result

in the PEP, and nor are marks or final score awarded. There is, instead, an emphasis on providing feedback.

Completion of the units and quality of the work alone does not indicate progression or competency but may be

used in an overall assessment when looking at all the assessments of the PEP. However, feedback provided to

participants through the assessment report for the learning units is very important and the main focus of the

report.

There are two components of the assessment to consider. One is the overall assessment as rated against

standard criteria. This will provide a global rating of ‘at the standard’, ‘progressing towards the standard’ or

‘significant margin for improvement’ for the task. The second component is specific written feedback to the

participant.

A template for the assessment has been provided (Appendix C). This template is used with all activities. The

marking rubric (Appendix D) applies to common elements of assessment activities and assesses the level of

engagement in learning, ability to reflect and overall quality of work. Criteria for this assessment are included in


the template. Use the performance lists in the rubric to make an overall assessment of how the participant is

performing against each of the relevant criteria. The question being asked is: ‘Is this participant performing at

the standard expected?’

Written feedback is provided about the individual activity content via the assessment template. This feedback

can also be discussed with the participant at their mentor meetings.

A suggested approach to assessing the tasks:

1. Read the task.

2. Consider briefly reviewing the other tasks in the unit to provide context and additional information on the

standard of work.

3. Make an overall assessment using the template provided via the LMS.

4. Provide written feedback.

The written feedback is approached in terms of what has been done well, what needs improvement and

suggestions for achieving this.

The feedback and report go to the participant. Therefore, there are some important points to note in writing the

feedback:

Address the participant directly in the report.

Use supportive language and try to offer specific examples and practical suggestions.

Try to avoid abbreviations where possible.

Remember that if in your assessment you comment about written skills, you need to ensure that your spelling and grammar are also well done!

Feedback for case studies

Many of the case studies use a template that guides the participant to reflect on relevant aspects of history-taking,

examination and management, as well as to offer insight into clinical reasoning (through questions about

differentials, red flags etc) and aspects related to the ethical, legal and communication aspects of each case.

As you would with a case-based discussion, think about:

Did the participant identify the important aspects of the history and examination, including the psychosocial?

Did they demonstrate sound clinical reasoning?

Were there any important diagnoses not considered?

Were investigations appropriate and justified?

Was the management plan reasonable and sufficiently detailed?

Are they able to reflect on the effectiveness or otherwise of communication?

Are they able to reflect on the important issues in the case and refer to relevant guidelines?

Are they able to identify relevant practice systems?

Are there any outcomes recorded and reflection about these? Do these indicate insight into important aspects of the case?

Are there any further resources or learning activities that you can identify that might assist?

Feedback for other activities

What activity has been undertaken? Is evidence of completion required and has this been provided?

Has enough detail been provided about the activity?

Describe the quality of the reflection. Does this demonstrate the ability to translate what has been learned into practice?

Are there any further resources or learning activities that you can identify that might assist?


General feedback

Was the written communication clear and appropriate to the task?

Is the participant able to reflect on what they have learned and how they will apply this in their practice?

Are they able to reflect on their learning needs?

Are they able to reflect and select cases relevant to their scope of practice?

Did they engage with the task?

Feedback for the PEP Specialist Stream task

The learning unit assessment for the PEP Specialist Stream consists of a single reflective essay. Participants are

asked to reflect on their learning and in-practice experience with specific reference to:

a comparison between previous experience in general practice and the Australian context

the challenges in their current practice and how to manage these

key points from the learning units and areas for future learning.

The assessment is made of the completion and quality of the reflection and the participant’s ability to provide a

meaningful reflection about present and future learning (WBA competency 6 – Professionalism). The feedback

can refer to:

the quality of the writing and comprehensiveness of the responses

the level of detail, quality of the comparison and ability to reflect on how past general practice experience can be applied to current practice

ability to reflect on current practice and identify supports – the assessor may make suggestions to assist with supports or future learning activities

the quality of the reflection about learning – whether this demonstrates the ability to translate what has been learned into practice

whether there is ability to reflect on strengths and weaknesses and whether future learning needs target these appropriately

any further resources or activities that the assessor can suggest that might assist with future learning.

Multisource feedback (MSF) discussion

Each participant will complete one MSF. This is comprised of colleague and patient evaluations, a reflective

exercise and a discussion with an ME. The ME needs to discuss the participant’s reflection on the results.

The participant should then document points raised in the discussion and upload this to the portal.

Completion of the program The program is individually focused in that participants complete the program in the way that best maximises their

individual learning needs. They are provided educational opportunities, resources and support to make the most

of their time in the program. They may choose to leave the program before completion or to only complete certain

aspects, but they are encouraged to make the most of the opportunities offered.

Progression through the program is monitored through feedback and assessments. Where it is felt that this is not

satisfactory, remediation may be offered although this is at an additional cost and a participant may choose to

decline.

Currently, it is not an eligibility requirement to have completed a program in order to sit the RACGP Fellowship

exams. This will change from 2022 onwards.


Reporting on progress Mentors might be required to provide input into the participant’s progress and completion reports. The reporting is

completed using a standard template and reflects progress in areas such as learning unit completion and

assessments undertaken.

Raising concerns If there are concerns about any aspect of the participant’s performance or progress, they should be addressed

in accordance with the TO’s policies and procedures. If an ME identifies a participant they believe requires

additional support, this should first be escalated to the TO. The TO will then liaise with the RACGP PEP team

if required.

Maintaining boundaries

The mentor needs to ensure appropriate boundaries in the relationship with their participant are in place and

clearly articulated from the outset. The mentor is not expected to provide clinical advice and should avoid doing

so. Maintaining a strictly professional relationship is important.

Communication should be via agreed channels only, and mentors are advised to follow the agreed procedures.

What to do if things go wrong

Some of the risks of mentoring include:

lack of agreement between mentor and participant about the expectations of the mentoring role

lack of interest or commitment to the program by either mentor or participant

personality clashes between mentor and participant

overdependence by participant on the mentor (especially if personal issues arise)

failure of mentor to foster goals and address self-identified needs of the participant, and instead imposing their own goals, beliefs and approach on the participant

inappropriate behaviour by either party

negativity at termination of the relationship (termination may occur through participant choice, a mentor ceasing their role, or at the end of the program).

The best prevention for problems is following guidelines by setting out the commitment required, and establishing

objectives and the expectations of the relationship at the outset.

However, even with the best of intentions and the best structure and support within a program, things can go

wrong, and a mentoring relationship may not prove successful. How this is managed depends on the cause of the

problem. TO support and appropriate procedures will be relevant in this situation.

Conflicts of interest

Consideration should be given to instances where knowledge of, or interactions with, the participant might

influence the ability to provide a suitable mentoring relationship.

The mentor must not be:

a relative or domestic partner of the participant

an employee or employer of the participant.

Ideally, the mentor should not have a close personal relationship with the participant.

Confidentiality

Mentors are reminded that the material they work with in the PEP is confidential and should be treated as such.

It should not be reproduced or passed onto other parties unless required as part of the PEP, and when authorised

in writing by the RACGP or by law.


On termination or expiry of their appointment, mentors must immediately return to the RACGP (or, if so

requested, destroy) all documents containing any confidential information.

PEP evaluation Evaluation of the PEP will be critical to inform ongoing program development and improvement. The evaluation

will help to:

determine the needs of non–vocationally registered doctors and facilitate tailored participation in the PEP

monitor and report program implementation to determine and document progress in achieving the key program objectives

investigate the extent to which program objectives and expected outcomes are achieved, and the enablers and barriers surrounding these outcomes

inform ongoing program improvement.

The RACGP will manage the formal evaluation of the PEP, and has appointed an evaluation coordinator for

this role.

You will be asked to participate in a number of activities during your participation to assist in the program’s

evaluation. These may include:

responding to short online surveys

participating in focus groups or interviews.


Acronyms and initialisms AGPT Australian General Practice Training

GP general practitioner

ICSA Initial Core Skills Analysis

IMG international medical graduate

LMS learning management system

ME medical educator

PEP Practice Experience Program

QI&CPD

Program

Quality Improvement and Continuing Professional Development Program

RACGP Royal Australian College of General Practitioners

TO training organisation

WBA workplace-based assessment

Definitions

Term Definition

Applicant A medical practitioner who is applying for entry to the PEP

Assessment The systematic process for making judgements on the participant’s progress, level of

achievement or competence against defined criteria

Feedback Specific information about the comparison between a participant’s observed performance and a

standard, given with the intent to improve the participant’s performance

Medical

educator

(ME)

An individual who provides education in the domain of general practice. Their responsibilities

may include education, support and guidance, networking and stakeholder relations,

organisational support and professional development

Mentoring A professional relationship in which an experienced person assists another to develop specific

skills and/or knowledge important for their professional and personal growth

Participant A medical practitioner who has been accepted into the PEP, and has signed a Learning

Agreement with the RACGP

Performance What is actually undertaken in practice

Portfolio A collection of evidence of learning progress and completion. Can include quantitative data

(eg test scores) and qualitative data (eg mentor reports, self-reflections, practice visit reports).

It allows real-time monitoring by both learners and faculty of progress towards Fellowship, with

opportunity for remediation of areas of weakness. It will also include an activity logbook

Progress Demonstrated improvement in clinical skill

Workplace-

based

assessment

(WBA)

The assessment of day-to-day working practices undertaken in the working environment.

WBAs enable assessment of competencies in a real-world setting


Reference 1. Kilminster S, Cottrell D, Grant J, Jolly B. AMEE Guide No. 27: Effective educational and clinical supervision. Med Teach

2007;29(1):2–19.


Appendix A. Background information – Summary of the Practice Experience Program To enter the Practice Experience Program (PEP), participants need to complete the PEP Entry Assessment

(PEPEA) satisfactorily, unless they were granted an exemption.

They then complete the Initial Core Skills Analysis (ICSA). The ICSA includes 150 multiple choice questions

(MCQs) matched to the learning units, a self-reflection and video analysis. Combined with information from their

curriculum vitae (CV) about previous experience, scope of practice and recency, and their CPD records, an

individual learning program time is made and learning units recommended. Once in the program, the following are

completed by all participants.

Time in the program: this is the time spent working in general practice. The minimum time in the PEP

Standard Stream is two terms, and the maximum is five terms. One term is six calendar months long.

PEP participants can work full time or part time while on the program. The minimum part-time hours that need

to be maintained are 14.5 hours per week over at least two days per week. In order to also complete the

educational part of the program, it is recommended that a maximum of 38 hours per week is worked if full

time. The education program consists of learning units for which the time commitment is the same irrespective

of full- or part-time clinical work.

Learning units: five units are completed each term (Figure A1.1). Some are core units that should be

completed in Term 1, the remainder are selected from a range of options. On average, learning units take about 30 hours to complete; therefore, 150 hours of study each term are expected. There is one assessment task in each unit, but participants do not know which of the tasks is the assessment task.

Workplace-based assessments (WBAs): a number of assessments are based in the workplace to provide

feedback about progress towards the standard expected at the point of Fellowship. These assessments are:

direct observation of consultations using a Mini-Clinical Evaluation Exercise (Mini-CEX), which occurs every term

clinical case analysis, which can be through random case analysis and/or case-based discussion, and which occurs every term

multisource feedback, which is completed once during the program.

Learning plan: this needs to be maintained throughout the program.

Logbook of procedural and examination activities: this is also completed during the program.

Contact with a medical educator (ME) mentor: the ME from the training organisation (TO) meets with the

participant during the term.


Figure A1.1. PEP timeline

ICSA, Initial Core Skills Analysis; ME, medical educator; MSF, multisource feedback

Fellowship exams

The Royal Australian College of General Practitioners’ Fellowship exams (FRACGP) are completed after the

educational phase of the program. A participant can enrol in the exams while in the PEP but cannot sit them.

This is to allow those near the end of their program time to enrol and sit shortly after they complete their program.

Because they are unable to sit exams while in the program, a participant’s exam attempt time is suspended –

that is, PEP time does not contribute to the three-year cap on exam time.

Exam enrolment requires a current general practice experience (GPE) assessment showing at least:

four years’ full-time equivalent (FTE) general practice experience in the last 10 years

one year’s FTE general practice experience in the last four years

one year’s FTE Australian general practice experience in the last four years

six months’ FTE in comprehensive Australian general practice experience in the last four years.

Notes:

1. A GPE assessment is a comprehensive review of previous experience in Australia and overseas. It cannot be

assumed to be the same as what has been recorded on the participant’s CV, as factors such as scope and hours

will also influence the result. The ICSA uses Australian general practice time only in the determination of program

time. This is based on the CV supplied if a GPE is not available. Therefore, it should not be assumed that the ICSA

time will necessarily be the same as the GPE. It is the GPE time that is used in determining exam eligibility.

A GPE application is required and can take at least 12 weeks; this needs to be considered when a participant is

thinking of enrolling in the exams.



2. From 2022, it is expected that all applicants will need to have completed a program (AGPT or PEP) in order to sit

the exams.

Provider numbers

During the PEP, participants access a provider number that allows them to bill at A1 Medicare rates. If they

complete the PEP satisfactorily they can continue to access a provider number for up to three years after

completion in order to allow them to continue to work towards exam eligibility and sit the exams.

Satisfactory completion of the PEP means participants have:

engaged in the program – with mentors, TOs and RACGP

completed assessments, including learning units

worked in the PEP-approved general practice for at least the minimum part-time hours throughout the program

demonstrated an ability to self-reflect.

If participants do not complete the program satisfactorily they may lose access to their provider number in the

post-education phase.

The provider number extension requires that participants make a genuine effort to achieve Fellowship. It is

expected that they will enrol and sit the Fellowship exams as soon as they are eligible after completing the PEP.

They are also expected to continue working the minimum part-time hours.

If a participant is not eligible for the exams at the end of three years, their provider number will not be extended

further. However, in certain other circumstances, the provider number may be extended further such as in

extenuating and unforeseen circumstances or while awaiting Fellowship. These are outlined in the PEP policies.

Costs

Participants pay for participation in the program and also receive a subsidy from the government. Any participant

who leaves the program early and later reapplies and is accepted will not be eligible for a funding subsidy from

the government, so will need to meet the full costs of the program.

Withdrawal

Participants can voluntarily withdraw from the program at any time and can reapply in the future, but acceptance

back into the program is at the discretion of the RACGP.

Participants can also be withdrawn if they cannot meet the terms of participation through issues such as changes

to medical registration, misconduct, failure to maintain appropriate employment, failure to pay co-payment, and

failure to meet the educational requirements or engage in the program.

Remediation

Remediation in the PEP may be recommended by a TO, but is optional. There is a maximum time of six months

for remediation and it is completed in addition to the PEP time. Remediation activities are determined and

completed based on needs as identified from a formal assessment.

More details can be found in the PEP polices.

https://www.racgp.org.au/education/imgs/fellowship-pathways/fellowship-programs-for-imgs/practice-experience-program/practice-experience-program-standard-stream/pep-policies


Appendix B. List of PEP learning units Core units (completed by all participants)

1. Core unit 1: Practising in context

2. Core unit 2: Safety

3. Core unit 3: Emergencies and disaster management

4. Core unit 4: General practice specific skills

5. Core unit 5: Evidence in practice

6. Core unit 6: Communication and consulting skills

7. Core unit 7: Aboriginal and Torres Strait Islander health

Elective units (selected by participants)

1. Children and young people

2. Adult medicine – Cardiovascular

3. Adult medicine – Rheumatology

4. Adult medicine – Respiratory

5. Adult medicine – Gastrointestinal

6. Adult medicine – Haematology

7. Adult medicine – Endocrine

8. Adult medicine – Neurology

9. Adult medicine – Renal/urology

10. Adult medicine – Infectious disease

11. Pregnancy care

12. Care of older persons

13. Women’s health

14. Men’s health

15. Sex, gender and sexual diversity

16. Sexual and reproductive health

17. Individuals with disabilities

18. Travel medicine

19. Addiction medicine

20. Abuse and violence

21. Psychological health

22. Dermatology

23. Eye medicine

24. Ear and nose medicine

25. Musculoskeletal and sports medicine

26. Oral health

27. Oncology

28. Palliative care and pain medicine

29. Residential care

30. Refugee and asylum seeker health


Appendix C. Learning unit assessment form (template)


Appendix D. Learning unit assessable task rubric



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Practice Experience Program (PEP) · 2020-03-10 · Practice Experience Program (PEP): Mentor guide. Version 2020.2 Disclaimer The information set out in this publication is current