Quality Assurance of the curriculum

Standards for postgraduate surgical education

The foundations of the framework are the standards for postgraduate surgical education, established by the SACs and built on the GMC’s generic standards for postgraduate medical education. GMC generic standards for training.

These standards, specific to surgical disciplines, together with the indicative evidence requirements and judgements of specialists in the surgical disciplines provide a form of peer-assessment that can provide authoritative judgements on the quality of learning experiences for trainees. It is important to ensure that trainees’ experience of the curriculum forms a major part of the approach to quality assurance and this will be undertaken by means of a sophisticated survey of trainee views.

One of the key determinants of the quality of a curriculum is the quality of those delivering it, and it is important that quality of training is evidenced. The GMC has produced its standards for trainers which are being developed into curriculum standards for surgical trainers to help confirm that Assigned Educational Supervisors and Clinical Supervisors meet these standards through ISCP website registration.

Surgical trainee experience survey

This online survey is focussed on surgical training standards and trainees' experience of the curriculum. Moreover, it enables analysis of individual surgical specialties and the extent to which the curriculum and standards for specialties are maintained at specific levels of training. It will produce comparative evidence at a number of levels, for example:

• schools of surgery level, to allow cross-deanery benchmarking as specified by JACSTAG
• inter-specialty level within schools of surgery, for internal benchmarking
• specialty level within schools of surgery
• specialty level nationally, for SACs
• post level within specialties.

The survey remains, however, an opinion survey and is a single source of evidence which must be triangulated. This is achieved, initially, through reports from Training Programme Directors and SAC members’ participation in ARCP processes and will in future seek other quantitative measures, such as measures of surgical experience through logbooks.

Annual monitoring

The annual monitoring process, carried out by the deanery/school of surgery, is an important reporting process that allows the programme(s) to periodically evaluate their delivery, operation and outcomes. The process is one of evidence-based self-evaluation, utilising feedback from a range of key stakeholders that will result in ongoing action plans.

The process requires critical evaluation of main areas of activity and it is intended that these would correspond to the standards for postgraduate surgical education, which in turn reflect GMC generic domains. The findings of the surgical trainee experience survey and ARCP outcomes are crucial qualitative measures of trainee perceptions and performance. These are supplemented by the programme directors’ critical account of all the significant aspects of training.

Deanery/SAC reviews

It is anticipated that where evidence from trainee evaluation and/or annual monitoring indicates specific concerns about the quality of training, the deanery, with necessary specialist support provided by the SAC, may initiate a review process. This process will be proportionate to the nature of the concern and may utilise a documentary analysis and/or visits, in line with the Joint Academy and COPMeD Specialty Training Advisory Group (JACSTAG) recommendations.