Patient Clinical Interaction Assessment FAQs

The PCIA is an assessment conducted by a PCIA assessor and undertaken in the workplace during Advanced Training where trainees and SIMGs are observed interacting with a patient to elicit a history, undertake a physical examination and present these findings to a workplace assessor. Following the observed history and examination, the PCIA assessor will engage the trainee or SIMG in a discussion to ascertain their comprehension of the patient’s comorbidities regarding perioperative issues, including risks, optimisation and planning prior to surgery. An educationally focussed feedback conversation will follow.

The purpose of the PCIA is to determine if the trainee or SIMG can be entrusted to provide pre-operative care for patients with significant co-morbidities including pre-operative assessment and risk stratification, preparation and optimisation prior to surgery without supervisory input.

The learning outcomes assessed in the PCIA are mapped to the MiniCEX perioperative assessment M-CEX PO1AT, which it replaces from 2025.

The PCIA is being introduced to restore that component of the FEx Medical Viva that previously included direct observation of trainees’ interactions with complex comorbid patients to elicit a clinical history and examination. This was removed from the FEx in 2020, because of restrictions imposed by the COVID 19 pandemic.

No. The key difference between the PCIA and the new format FEx Medical Viva exam, introduced in 2020, is that the PCIA involves real time observation of the trainee interacting with a real patient in the clinical environment.

Each hospital that is accredited within the ANZCA Anaesthesia Training Program that has Advanced Trainees or SIMGs on the exam route is expected to support the PCIA assessment.

The PCIA may take place in the pre-assessment clinic, or in another hospital setting, provided that the criteria for the assessment are fulfilled.

PCIA will be a requirement for all trainees entering Advanced Training (AT) from 2025 Hospital Employment Year, and SIMG’s (who have the requirement to sit the exam) beginning in their SIMG pathway from the 2025 Hospital Employment Year. Those who commenced AT or an SIMG pathway prior to 2025, are not required to complete the PCIA.

The PCIA can be undertaken at any time within Advanced Training (AT) and the equivalent period for SIMGs and must be successfully completed and documented to progress to the Provisional Fellowship Year (PFY) at the core unit review. 

Completion of the PCIA is not a prerequisite for eligibility to enrol in the ANZCA Final Exam (FEx).

The PCIA assessor is responsible for selecting the PCIA case. With reasonable notice, trainees and SIMGs should advise the lead PCIA assessor and the Supervisor of Training (SOT) for their department of their requirement to undertake a PCIA during their term within the Anaesthesia Department. Trainees and SIMGs should not be required to undertake the PCIA until they feel prepared to do so.

A minimum of one successfully completed and documented PCIA is required which demonstrates that the trainee or SIMG could be entrusted with preoperative assessment of complex comorbid patients.

There is no limit to the number of PCIA attempts that can be undertaken with a PCIA assessor to reach the required standard. A minimum of one successfully completed and documented PCIA is required to progress to the Provisional Fellowship Year (PFY) at the core unit review or for SIMGs to apply for fellowship.

Trainees and SIMGs must demonstrate that they could be entrusted with preoperative assessment of comorbid patients of ASA III or above complexity. A scoring rubric will be available to trainees, SIMGs and assessors to support the assessment.

Supervisors will provide you with detailed feedback on each attempt which should guide future preparation. Practice PCIAs may be able to be organised outside of the formal PCIA assessment. ATs will not be able to proceed from AT to PFY and SIMGs will not be able to apply for fellowship, if the PCIA is not successfully completed.

You can fail a PCIA, however, you can repeat it. Failed/unsuccessful attempts are not recorded in the TSP or SIMG e-portfolio.

Unsuccessful attempts will not be recorded on the TPS or in the SIMG e-portfolio, however, the number of attempts is recorded on the PCIA form.

The PCIA will be conducted by the PCIA Assessor at the training site.

PCIA assessors are anaesthetic consultants who are members of the trainee or SIMGs’ department. They have expertise in management of patients with complex co-morbidities and will ideally also have a special interest or expertise in perioperative medicine. PCIA assessors are appointed by the Head of Department (HOD) and this appointment is noted by the relevant state or national Education Officer. PCIA assessors will complete a short online training module in order to undertake the role.

The PCIA is marked on a standardised rubric which uses the ANZCA entrustment scale to make the decision that the trainee either can be trusted with the pre-operative assessment of a patient with significant co-morbidities, or that they have not yet reached this stage, and still require supervisory input into this assessment. The scoring rubric will be available to trainees.

The PCIA is mapped to specific learning outcomes in the ANZCA curriculum, and these will be made available. Resources for PCIA assessors will also be made available to trainees, including the assessment forms.

Only mobile phones are allowed during the assessment. Any large devices, such as laptops, will be not permitted. Materials can be taken into the PCIA that would normally be used at the bedside or in clinic to stratify a patient’s perioperative risks and or to optimise their preparedness for surgery. Examples of acceptable materials include tools that quantify perioperative mortality (e.g. NSQIP), functional status (e.g. DASI questionnaires) or to classify disease states (e.g. Haematological disorders). It is impractical to rely upon references materials that require lengthy review or for the purposes of knowledge revision.

The Head of Department is required to appoint one or more PCIA assessor depending on the number of Advanced trainees in their department. Assessor criteria and responsibilities are currently being developed and information packs will be distributed to Heads of Department in the coming months.

Contact your Head of Department. An online training module (max 45mins) must be completed to ensure you understand the purpose, process and required standards for successful completion of a PCIA.

A PCIA assessor is a formal ANZCA appointment and will build an educational CV for those wishing to undertake further roles in ANZCA e.g. on Committees or Examination panels.

Opportunities for CPD for PCIA assessors are currently being investigated. Updates will be provided as information is confirmed.