for a satisfactory trainee
of Clinical Expertise (ACE/ Mini-ACE )
telling of the story, effectively uses appropriate questions to
obtain accurate, adequate information, responds appropriately to
verbal and non-verbal cues.
||Explores the patient’s perspective, jargon-free,
open and honest, empathic, explains treatment, including different
options, the effects of treatment (likely benefits, common and
serious side-effects), consequences of not treating and (in the
case of procedures) details of what to expect during it. Agrees
management plan/therapy with patient.
||Makes appropriate diagnosis and formulates a suitable management
plan. Selectively orders/performs appropriate diagnostic studies,
considers risks/benefits. Refers appropriately to other members
of the MDT or other services.
||Shows respect, compassion, empathy, establishes trust; attends
to patient’s needs of comfort, respect, confidentiality.
Behaves in an ethical manner, awareness of relevant legal frameworks,
including the Mental Health Act. Aware of limitations.
|| Prioritises; is timely, succinct. Summarises.
|Overall clinical care
|| Demonstrates satisfactory
clinical judgement, synthesis, caring, effectiveness, efficiency,
appropriate use of resources, balances risks and benefits, awareness
of own limitations.
||Clinical record keeping
||The record is legible, signed, dated and appropriate to the
problem, understandable in relation to, and in sequence with,
other entries. The content of the record conforms to Trust and
NICE guidelines (where such exist). It helps the next clinician
who uses the record, to give effective and appropriate care.
||Can discuss how they understood the patient’s story and
how through further inquiry appropriate to the patient’s
problem and situation, the trainee was able to arrive at a concise
formulation of the patient’s problem from which further
action could be derived.
|Risk assessment and management
||Can discuss the relevant information from the patient’s
history and integrate this with knowledge of the key risks relevant
to psychiatry to produce a concise risk assessment that would
allow the development of a risk management plan. Appreciates
the need for ongoing risk assessment and is aware of the place
and the limitations of risk assessment tools and rating scales.
The trainee is able to integrate NICE guidelines to the assessment.
Can discuss the rationale for the risk management plan, including
the reasons for using or not using powers under the Mental Health
||Can discuss the rationale for the treatment, including the
risks and benefits. The trainee refers to appropriate guidelines
(eg NICE) where they are available.
|Investigation and referral
||Can discuss the rationale for any physical investigations ordered,
for further enquiries that were conducted and for referral to
other agencies or to members of the mental health MDT. Can demonstrate
awareness of the ethical and legal frameworks for sharing information.
|Follow-up and care planning
||Can discuss the rationale for the formulation of the management
plan including follow up and referral to other agencies or members
of the mental health MDT.
||Can discuss how the care of this patient, as recorded, demonstrated
respect, compassion, empathy and established trust.
Can discuss how the patient’s need for respect and confidentiality were
attended to. Can show how the record demonstrated an ethical approach and awareness
of the legal framework. Has insight into own limitations.
|| Is able, with sound reasoning,
to articulate the steps along the clinical pathway for each of
the decisions that were taken.
|Overall clinical care
||Can discuss own judgement, synthesis, caring, and effectiveness
for this patient at the time that this record was made.
||Assessment and Clinical examination
||A systematic and logical presentation. The
Mental State Examination and physical assessment should be accurate
and appropriate demonstrating core (psycho)pathology. May have
some omissions and/or inaccuracies but must be a systematic and
|Interpretation of Clinical Evidence
||An adequate differential diagnosis with no
serious omissions. Could include a consideration of aetiology.
|Use of Investigations
||Recognises need for many of the investigations
required for informing diagnosis and management plan.
|Presentation and Delivery
||Adequate communication but some problems
such as inappropriately slow delivery or signs of anxiety. Adequate
use of audio/visual aids.
|Journal Club Presentation
||Introducing the topic
||A clear, appropriately structured introduction
covering all the main points.
|Setting material in context
||The material is clearly set in relevant contexts of clinical
work, other research etc.
|Analysis and critique
||A careful, fairly thorough analysis and critique, well explained,
with no significant omissions.
|Presentation and Delivery
||An adequate presentation, reasonably well organized and clearly
delivered with appropriate use of audio/visual aids.
||Generally gave clear and correct answers. Perhaps might have
admitted not knowing some answers.
||A good, worthwhile experience with clearly identified educational