Experiences of UK general practice trainees undertaking workplace-based assessment who received a developmental outcome at their annual review of competency progression

Workplace-Based Assessment (WPBA) forms part of the integrated assessment system for UK General Practice (GP) licencing. An Annual Review of Competence Progression (ARCP) panel evaluates either satisfactory progress or requirement for development of specific capabilities. We aimed to explore GP trainees' experiences of undertaking WPBA when failing to progress by receiving a 'developmental' outcome 2 or 3. We used a qualitative design employing Systematic Grounded Theory and semi-structured interviews. A purposive sample of GP trainees was recruited, at different stages of training and with varying demographic characteristics, who had a previous ARCP developmental outcome. Interviews were recorded, transcribed verbatim and analysed, facilitated by NVivo 14. We interviewed 20 GP trainees during 2024 who received a developmental outcome between 2020 and 2023. We identified five themes: 'potential for early intervention', included personalised support and better information provision; 'perceptions of how WPBA reflected trainee performance' including perceptions of the validity and reliability of WPBA and need for fair, trustworthy and transparent processes to reduce unfair discrimination; 'communication difficulties' arose in relation to culture, language and reflection for some study participants; 'relationships with peers and educational setting' were felt to affect performance; and some participants experienced negative 'effects on wellbeing'. Suggestions aimed at supporting and overcoming potential challenges to undertaking WPBA during GP training, including personalised support, reviewing fairness of assessments, addressing communication and cultural barriers, enhancing training environments, fostering positive relationships, and mitigating negative wellbeing impacts, some of which were already in place, with others requiring development.