Assessment Forms & Stage Certificates

All trainees in the UK are now expected to undertake Workplace Based Assessment [WPBA]. Trainees on the Single or Dual Programmes should now be using the e-Portfolio rather than the paper forms below. For more information, please click here. ICM trainees not on the Single or Dual Programmes will still be using the forms below. More details on assessment can be found in Parts I and II of the CCT in Intensive Care Medicine.
 

Please note that whilst the ACAT is an accepted assessment for ICM training, the form and its associated guidance are created and maintained by the JRCPTB. Please click here for further information.
 

If you are looking for sign off forms for a block of training in Basic, Intermediate or Advanced ICM, these can be found within the Joint CCT Curriculum Manuals.
 

To provide feedback on the assessment documentation please contact the Faculty.

 

Please click on the links below to be taken to the Assessment Documents:

WPBAs

Case Summaries (these have been removed from the curriulum from August 2017)

Logbook Summary

Stage Certificates

 

WPBAs

DOPS assessment form for Intensive Care Medicine

 

CbD assessment form for Intensive Care Medicine.

 

Mini-CEX assessment form for Intensive Care Medicine

 

ACAT assessment form 

 

Guidance on the use of the ACAT assessment tool

 

MSF-TAB assessment form for Intensive Care Medicine

 

Summary feedback form for Educational Supervisors on MSF-TAB assessments

 

Guidance on how trainees and trainers should get the most out of their MSF-TAB assessments

 

Case Summaries (these have been removed from the curriulum from August 2017)

Marking sheet for the 10 Expanded Case Summaries completed by ICM trainees

 

Guidance on the marking system for Expanded Case Summaries

 

Guidance for trainees on completing their Expanded Case Summaries

 

Logbook Summary

ICM logbook summary for trainees Please note: The FICM does not currently issue a full logbook for trainees.

 

Stage Certificates

Training certificate to be issued by ICM RAs to ICM CCT trainees only who have completed all the requirements of Stage 1 of the ICM CCT curriculum.  This certificate is not for use by trainees outside the ICM CCT programme.

 

Training certificate to be issued by ICM RAS to ICM CCT trainees only who have completed all the requirements of Stage 2 of the ICM CCT curriculum.  This certificate is not for use by trainees outside the ICM CCT programme.