Box 1.

Implications of this work

Impact on local training programme
  • A session dedicated to preparation for the ARCP is now delivered to all new ST3s as part of regional induction.

  • ARCP discussion sessions have been integrated into the regional structured teaching programme.

  • Individualised structured feedback about the ES report is sent to all supervisors following every ARCP.

Potential considerations for the ARCP process
  • How can the positive impact of curriculum documents (such as the ARCP decision aid) be retained to promote assessment driven learning while avoiding a reductionist approach to training and curtailing assessment driven performance?

  • Why does the ARCP process appear to result in stress and disillusionment for trainees in this and other studies? How might this be addressed? Does this necessitate a wider acknowledgement and open discussion of the limitations of the ARCP as a summative assessment upon which decisions regarding progression through training are made?

  • How can trainers be best prepared for the challenges of bridging the gap between curriculum concepts of competence and competence in practice? Will planned curriculum reforms support trainers in this endeavour?

Areas for further research
  • To what extent are the findings of the current study applicable to the ARCP in other training programmes and regions?

  • What is the role of the hidden curriculum in influencing postgraduate training? How does this relate to curriculum and ARCP requirements?

  • How can a concept as complex as consultant-level competence be effectively defined and evaluated in practice?

  • ARCP = annual review of competence progression; ES = educational supervisor; ST3 = specialty training year-3 doctor.